耳内镜下应用耳屏软骨-软骨膜复合体行鼓室成型术的效果研究

Efficiency of otoscopic auricular cartilage-perichondrium complexes in treatment of patients with tympanoplasty

目的探讨耳内镜下应用耳屏软骨-软骨膜复合体行鼓室成型术的临床效果。方法选取鼓膜穿孔需行Ⅰ型鼓室成型术患者79例,随机分为观察组39例与对照组40例。观察组患者采用耳内镜下耳屏软骨-软骨膜复合体行鼓室成型术修补鼓膜;对照组患者采用显微镜下颞肌筋膜鼓膜行鼓室成型术。比较2组患者术后1月与1年的鼓膜愈合情况,术前、术后1年气导听阈及气骨导差的变化情况。结果观察组患者手术时间、术中出血量、住院时间、住院费用均显著优于对照组患者(P<0.05);观察组患者术后1月、1年鼓膜愈合率分别为94.87%、87.12%,均显著高于对照组的82.50%、72.50%(P<0.05)。2组患者术前气导听阈与气骨导差无显著差异(P>0.05),术后1年观察组患者气导听阈与气骨导差显著低于对照组(P<0.05)。结论耳内镜下耳屏软骨-软骨膜复合体行鼓室成型术操作简单、创伤小、术后愈合率高,听力明显改善,住院费用低,值得临床推广应用。

Objective To explore the clinical effect of otoscopic auricular cartilage-perichondrium complexes on treatment of patients with tympanoplasty. Methods Totally 79 patients with tympanic membrane perforation by type I tympanoplasty were selected and randomly divided into observation group（ n = 39） and control group（ n = 40）. The observation group was treated with otoscopic auricular cartilage-perichondrium complexes,while the control group was treated with microscopic temporalis fascia for tympanoplasty. The tympanic membrane healing at one month and one year after operation,change of air conduction threshold and air bone conduction difference before treatment and one year after operation were compared between two groups. Results The time of operation,the amount of bleeding,the hospital stay and the cost of hospitalization in the observation group were significantly better than those in the control group（ P〈0. 05）. In the observation group,the healing rates of tympanic membrane at one month and one year after operation were 94. 87% and87. 12%,which were significantly higher than 82. 50% and 72. 50% in the control group（ P〈0. 05）. There were no significant differences in air conduction threshold and air bone conduction difference before operation（ P〉0. 05）,but the air conduction threshold and air bone conduction difference in the observation group were significantly lower than those in the control group at one year after operation（ P〈0. 05）. Conclusion Otoscopic auricular cartilage-perichondrium complexes has advantages of simple manipulation,small wound,high postoperative healing rate in treatment of patients with tympanoplasty,it can improve hearing and reduce hospital cost,so it is worthy of clinical application.