耳内镜下3种耳屏软骨技术在鼓膜修补中的临床应用

Clinical application of three kinds of auricular cartilage technology in tympanic membrane repair under otoendoscopy

目的探讨耳内镜下3种耳屏修补材料在鼓膜修补中的应用疗效。方法前瞻性纳入鼓膜穿孔患者67例(67耳),将67耳随机分为全厚软骨-软骨膜组(20耳)、岛状软骨-单层软膜组(24耳)、岛状软骨-双层软鼓膜组(23耳)。对术中手术操作难易程度及术后8个月时的鼓膜愈合率、听力恢复情况、鼓室是否有黏连进行比较分析。结果全厚软骨-软骨膜组术中铺设过程较岛状软骨-单层软膜组、岛状软骨-双层软鼓膜组相对容易。术后岛状软骨-单层软膜组8个月时仅出现1例术后鼓膜穿孔,其余患者术后鼓膜均愈合良好。3组患者的术后听力均得到明显提高,与术前比较差异有统计学意义。3组之间在听力提高和鼓膜愈合率上差异均无统计学意义。结论耳内镜下3种耳屏软骨技术行鼓膜修补术后均可获得良好的鼓膜愈合率和听力改善,但在术中操作难度上全厚软骨-软骨膜明显较其他两种软骨技术简单。

Objective To explore the application effect of three types of auricular screen repair materials under otoendoscopy in tympanic membrane repair. Methods Sixty-seven patients (67 ears) with tympanic membrane perforation were included prospectively. 67 ears were randomly divided into full thickness cartilage subchondral ossium group (20 ears), island cartilage single-layer soft membrane group (24 ears) and island cartilage subchondral soft tympanic membrane group (23 ears).The difficulty degree of operation during operation and the rate of tympanic membrane healing at 8 months after operation, the condition of hearing recovery and the adhesion of tympanic room were compared and analyzed. Results The laying process in group A was easier than that in group B and C. At 6 months after surgery, only 1 case of tympanic membrane perforation occurred in group B, and all the other patients healed well after surgery. The postoperative hearing of the three groups were significantly improved, which was significantly different from that of the preoperative group. There was no statistically significant difference between the three groups in the improvement of hearing and the rate of tympanic membrane healing. Conclusion After tympanic membrane repair by three kinds of auricular cartilage techniques under otoendoscopy, good tympanic membrane healing rate and hearing improvement were obtained, but there was no significant difference in selection.