双瓣法鼓膜修补术治疗鼓膜大穿孔

Myringoplasty with double flaps in treatment of large tympanic membrane perforation

目的 探讨双瓣法鼓膜修补术的临床治疗效果.方法 选择95例（112耳）鼓膜修补术患者,48例（54耳）采用双瓣法鼓膜修补术（双瓣法组）,47例（58耳）采用内植法鼓膜修补术（内植法组）,测定术前及术后6个月气导、气骨导差,比较两组临床疗效.结果 双瓣法组成功率为96.3％ （52/54）,内植法组为91.4％（53/58）,两组比较差异无统计学意义（P＞0.05）.双瓣法组有效率为92.6％ （50/54）,内植法组有效率为77.6％ （45/58）,两组比较差异有统计学意义（P＜ 0.01）.结论 双瓣法鼓膜修补术治疗鼓膜大穿孔能较好成型鼓膜并提高听力,有很好的临床效果,手术操作较简单,值得推广.

Objective To investigate the clinical effect of myringoplasty with double flaps in treatment of large tympanic membrane perforation. Methods Ninety-five patients （ 112 ears） with large tympanic membrane perforation were enrolled in this study, 48 patients （54 ears） were performed myringoplasty with double flaps （double flaps method group） and 50 patients （58 ears） were performed myringoplasty with underlay method （underlay method group）. The air conduction （AC） and air bone gap （ABG） were measured before operation and 6 months after operation. The clinical efficacy of two groups was compared. Results The successful rate in double flaps method group was 96.3% （52/54） and 91.4% （53/58） in underlay method group, there was no significant difference （P 〉0.05）. The effective rate in double flaps method group was 92.6% （50/54） and 77.6% （45/58） in underlay method group,there was significant difference （P 〈 0.01 ）. Conclusions Myringoplasty with double flaps in treatment of large tympanic membrane perforation can effectively mould tympanic membrane and improve hearing. The operation is worthy of spreading.