耳后进路夹层法与内植法鼓膜修补术疗效比较

Comparison of the Efficacy Between Postauricular Approach Sandwich Method and Underlay Method for Tympanic Membrane Repair

【目的】探讨并比较耳后进路夹层法与内植法鼓膜修补术疗效。【方法】收集需行鼓膜修补术患者80例（92耳），按手术方法分为夹层法组42例（46耳）与内植法组38例（46耳）。分别观察两组术后听力恢复情况、术前术后言语频率平均听阈、术后3个月鼓膜情况、术后6个月愈合率。【结果】术后听力恢复情况夹层法优于内植法（P ＜0．05）；夹层法术后言语频率平均听阈明显高于内植法（P ＜0．01）；术后随访3个月后两组引起再穿孔、鼓膜内陷的发生有统计学差异（ P ＜0．05）；术后6个月愈合率比较，夹层法优于内植法，两组有统计学差异（ P ＜0．05）。【结论】耳后进路夹层法与内植法鼓膜修补术短期疗效相当，但前者更有利于听力恢复，是治疗鼓膜穿孔的较为理想的方法。

Objective To explore and compare the efficacy between postauricular sandwich method and underlay method for tympanic membrane repair .[Methods] Totally 80 patients（92 ears） requiring tympanic membrane repair were collected and randomly divided into sandwich method group （ n =42 ,46 ears） and underlay method group（ n =38 ,46 ears） .Postoperative auditory rehabilitation ,pre-and post-operation speech frequency ,average auditory threshold ,tympanic membrane 3 months after operation and the healing rate 6 months after operation were observed .[Results] The postoperative auditory rehabilitation in sandwich method group was better than underlay method group（ P〈0 .05） .Postoperative speech frequency and average auditory threshold in sandwich method group were obviously higher than those in underlay method group （ P 〈0 .01） .There was significant difference in the incidence of reperforation and otopiesis 3 months after the follow-up between two groups（ P〈0 .05） .There was significant difference in the healing rate 6 months after the operation between two groups （ P 〈 0 .05） .[Conclusion]The short-term efficacy in postauricular approach sandwich method is the same as that in underlay method ,but it is more beneficial for auditory rehabilitation , so it is an ideal method for the treatment of tympanic membrane perforation .