耳内镜下自体脂肪鼓膜修补术疗效分析

Therapeutic effects of otoscopic myringoplasty with autogenous adipose tissue

目的探讨耳内镜下自体脂肪鼓膜修补的疗效。方法回顾性分析128例患者行自体脂肪鼓膜修补术,自体脂肪取自耳垂或腹部,对于鼓膜紧张部大穿孔一次修补不成功者,再次或多次行自体脂肪鼓膜修补术。结果一次性鼓膜修补成功120例,两次修补成功6例,3次修补成功2例,总治愈率100%,术后6个月复查电测听,言语频率听阈恢复到平均(21.4±8.6)dB,骨、气导差缩小至(10.2±4.6)dB。结论耳内镜下自体脂肪鼓膜修补术适合于鼓膜紧张部中央型穿孔,视野清晰,操作准确,患者创伤小,恢复快,对于鼓膜紧张部大穿孔,一次修补穿孔未愈者,可再次或多次行脂肪修补术。

Objective To investigate the therapeutic effects of otoscopic myringoplasty with autogenous adipose tissue. Methods 128 cases of otoscopic myringoplasty with autogenous adipose tissue, which were harvested from earlobe or abdomen, were analyzed. The surgical procedure might be repeated due to difficult closure for large tympanic perfora- tion. Results The perforation of tympanic membranes were successfully repaired with one myringoplasty in 120 patients, twice in 6 patients and three times in 2 patients. The total cure rate was 100%. Hearing examination six months postoperative showed the average threshold of pure tone air conduction was（21.4 ± 8.6）dB. The threshold difference between pure tone bone-conduction and air-conduction was only （ 10.2 ± 4.6） dB. Conclusion Otoscopic myringoplas- ty with autogenous adipose is a simple, easy and minimally invasive procedure, which can be applied in the repair of large central perforation of membrana tensa, and the patients with failed operation.