透明质酸膜脂肪移植技术在鼓膜成形术中的临床应用

The Clinical Application of Hyaluronic Acid Filmin Fat Graft Myringoplasty

目的回顾性对比分析透明质酸膜脂肪移植技术(HAF)和单纯脂肪移植鼓膜成形术(FGM)的手术成功率及听力预后,探索HAF的临床应用价值。方法选择接受FGM患者92例,其中HAF组49耳,FGM组43耳,年龄566岁(中位年龄33岁)。术后12个月随访电子耳镜及听力学检查。结果 HAF组鼓膜修补成功率为90%,而FGM组则为57.1%(P<0.05)。患者术后12个月接受听力学评估并计算气骨导差(ABG),HAF组为6.86±8.52,而FGM组则为18.32±13.44(P<0.05)。2组患者术后均未出现骨导听力下降的并发症,且鼓膜原位再穿孔的发生与鼓膜穿孔的位置并无相关性。结论脂肪移植鼓膜成形术可在门诊局麻下完成,尤其对于鼓膜局限性穿孔的患者,可作为首选手术方案,而透明质酸膜的应用可以有效提高脂肪移植技术的手术成功率。

Objective To investigate the clinical application of the hyaluronic acid film in fat graft myringoplasty, through com- pare hyaluronic acid film fat graft myringoplasty （HAF） with fat graft myringoplasty （FGM） on grade I tympanic membrane perforations and 12 -month postoperative hearing outcomes. Method 92 chronic otitis media without cholesteatoma patients had received the fat graft myringoplasty. HAF group had 49 ears and FGM group had 43 ears, the median age is 33 （ 5 - 66）. All the patients received the postoperative assessment after 12 months, including the otoscope and pure tone andiometry. Results Successful closure of the tympanic membrane was achieved inthe HAF group （90%） and in the FGM group （57.1% ,P 〈 O. 05 ）. The mean （SD） postoperative air - bone gap in the HAF group （ 6.86±8.52 dB） was significantly lower than in the FGMgroup （ 18.32 ± 13.44 dB, P 〈 0.05 ）. No postoperative complications were observed. The location of the perforation was not found to be an indicative failure. Conclusions The success rate of HAF is superior to that of FGM alone. Hyaluronie acid film can be used in fat graft myringoplasty to improve the sueeess rate of grade I tympanic membrane.