45例改良外植法鼓室成形术的随访分析

Retrospective Study of 45 Cases of Modified Overlay Tympanoplasty

目的对鼓膜穿孔暴露困难的慢性化脓性中耳炎采用改良外植法鼓室成形术治疗的疗效分析。方法回顾分析45例改良外植法鼓室成形术患者的临床资料,分析患者术前及术后气骨导差变化,总结术后疗效和并发症情况。结果术前平均ABG为29.78±10.06 dB HL,术后为22.94±11.75 dB HL,较术前差异具有统计学意义(P<0.05)。术后并发症包括鼓膜外移3例(3/45,6.7%)、鼓膜再穿孔1例(1/45,2.2%)、外耳道狭窄1例(1/45,2.2%)。结论改良外植法技术对于暴露鼓膜困难的鼓室成形术是一种有效的手术方法,鼓膜外移是其主要的并发症。

Objective To evaluate the effects of modified overlay tympanoplasty treating in chronic suppurative otitis media （CSOM） patients with difficult exposure of the perforation. Methods This study was a retropective review of 45 patients who underwent modified overlay tympanoplasty. The changes in the airbone gap （ABG） at the end of follow-up were compared with preoperative hearing ABG. The effects and the postoperative complications were also documented. Results The preoperative mean ABG was 29.78±10.06 dB HL and the postoperative was 22.94±11.75 dB HL,There were significant differences between the two（P〈0.05）.The postoperative complications included graft lateralization （3/45,6.7%）,tympanic membrane reperforation （1/45,2.2%） and external auditory canal stenosis （1/45, 2.2%）.Conclusions Modified overlay tympanoplasty is an effective technique for the difficult exposure of the perforation. The main complication in our cases is graft lateralization.