活动期和静止期中耳炎鼓膜成形术后疗效分析

The differences of myringoplasty performed in active and inactive inflammatory stage

目的:对比活动期及静止期2组慢性中耳炎患者接受内植法鼓膜成形术后的疗效,探讨鼓室炎症因素对鼓膜成形术后疗效的影响以及手术时机的选择。方法:炎症活动期组(A组)46耳,静止期组(B组)52耳,2组患者均接受内植法鼓膜成形术,术后12个月评估听力学改变及鼓膜完整性(移植筋膜存活)。结果:2组患者年龄及性别差异均无统计学意义(均P>0.05)。A组筋膜存活率为87.0%,B组为90.4%,2组差异无统计学意义(P>0.05)。A组和B组术前、术后气骨导差差异均无统计学意义(均P>0.05)。A组再穿孔率13.0%,B组为9.6%,2组差异无统计学意义(P>0.05)。结论:处于炎症活动期的鼓室条件并非鼓膜成形术的禁忌证,而且活动期中耳炎患者可以获得与静止期患者相同的手术疗效。

Objective：Through comparing of simple underlay myringoplasty performed in active and inactive inflammatory stage of the chronic otitis media,to explore how the tympanic cavity inflammation affect the outcome of the myringoplasty.Method：Forty-six ears were enrolled in active inflammation group（group A,n=46）,and52 ears were enrolled in inactive inflammation group（group B,n=52）.All the patients had received the simple underlay technique myringoplasty.The following-up with otoscope and auditory test had been done in post-operative 12 months.Result：There was no statistic difference of gender and age between two groups.The graft taken-up rate of the group A was 87.0%,that of group B was 90.4%,and there was no statistic difference between two groups（P〈0.05）.There was no statistic difference of auditory threshold in pre-operative period（P〈0.05）and the ABG closure in post-operative period（P〈0.05）between two groups.The re-perforation rate of the tympanic membrane also has no difference between two groups（P〈0.05）.Conclusion：There is no difference of the underlay technique myringoplasty between the active inflammatory stage and inactive inflammatory stage.The active inflammatory condition of the tympanic cavity is not the contraindication of the myringoplasty.