同期双耳鼓膜成形术22例临床分析

Clinical analysis of bilateral same-day myringoplasty for 22 cases with bilateral tympanic membrane perforation

目的探讨同期行双侧鼓膜成形术的可行性，并总结相关经验。方法对22例双侧鼓膜穿孔患者，同期行双耳内植法鼓膜成形术，比较术前、术后3个月的纯音听阈，观察患者术后不适症状和并发症情况。40例同期行单耳鼓膜成形术患者为对照组。术后随访1至3年。结果22例患者（44耳）术后听力平均提高18dB，鼓膜穿孔愈合41耳（93．2％）。双耳组术后耳闷堵塞感7例（12耳），对照组3例（3耳），二者差异具有统计学意义（校正0：4．5374，P=0．0332）。两组术后听力提高、鼓膜愈合率及其他不适症状均无明显差异（P值均〉0．05）。结论同期行双耳鼓膜成形术是可行的，但应告知患者术后可能会出现暂时性的双耳堵塞不适感。

Objective To investigate the feasibility of bilateral same-day myringoplasty and the indications for myringoplasty for patients with bilateral tympanic membrane perforation, and to summarize relevant experience. Methods Twenty-two patients underwent bilateral same-day underlay myringoplasty, and all cases were consistent with the indications for myringoplasty. The preoperative hearing and postoperative hearing at three months were compared, and the postoperative symptoms and complications were observed. Forty patients underwent monaural myringoplasty as the control group over the same period. All cases were followed up for 1-3 years. Results The postoperative hearing was increased by an average of 18 dB, and the rate of closure of tympanic membrane perforation was 93.2% （41/44）. There were seven patients with ear fullness after operation in the bilateral myringoplasty group and two patients in the control group（ ~2 = 4. 5374 ,P = 0. 0332）. There were no differences in the postoperative hearing improvement, the rate of closure and the rates of other discomfort symptoms except for ear fullness between the two groups（P 〉 0. 05 ）. Conclusion It was feasible and safe to perform bilateral same-day myringoplasty for bilateral tympanic membrane perforation, but the postoperative temporary discomfort of bilateral ear fullness should he informed the patients in advance.