耳内镜下与显微镜下鼓膜成形术的疗效比较

Comparison of the efficacy of endotoscpe and microscope tympanoplasty

目的比较耳内镜及显微镜下行鼓膜成形术的疗效。方法选择2014年6月~2016年6月四川宜宾市第一人民医院耳鼻咽喉科收治160例行鼓膜成形术的慢性化脓性中耳炎患者为研究对象。根据手术方式分为耳内镜组和显微镜组,各80例。比较两组平均手术时间、术中出血量和术后1个月、6个月、1年的鼓膜愈合率,术后3个月的听力改善情况。结果耳内镜组平均手术时间和平均术中出血量低于显微镜组(P<0.05);耳内镜组平均住院时间和术后干耳时间>1月患者比例低于显微镜组(P<0.05);两组术后1个月、6个月、1年鼓膜愈合率比较差异无统计学意义(P>0.05);两组术后平均气导听阈、平均气骨导差比较差异无统计学意义(P>0.05);两组术后平均气导听阈、平均气骨导差均低于术前(P<0.05)。结论耳内镜下鼓膜成形术与传统显微镜下鼓膜成形术相比,疗效相当,但具有手术时间更短、术中出血量更少、微创等优点,值得临床推广。

Objective To compare the curative effect of endotoscpe and microscope tympanoplasty.Methods One hundred and sixty patients with chronic suppurative otitis media treated by tympanoplasty in the department of otolaryngology,first people's hospital of Yibin City from June 2014 to June 2016 were selected as research object.According to the surgical methods,160 cases were divided into the endotoscpe group and the microscope group,80 cases in each group.The average operation time,the intraoperative bleeding volume,the healing rate of the tympanic membrane at 1 month,6 months and 1 year after operation,and the hearing improvement in 3 months after operation of the two groups were compared.Results The average operation time and the bleeding volume in the endotoscpe group were lower than those of the microscope group(P<0.05);The average time of hospitalization and the average percentage of postoperative dry ear time more than 1 month in the endotoscpe group were lower than those in the microscope group(P<0.05);There was no statistical significance in the difference of the healing rate of tympanic membrane at 1 months,6 months and 1 years after operation between two groups(P>0.05);There was no statistical significance in the difference of the average air conduction auditory threshold,the average air bone conductance gap between the two groups(P>0.05);The average air conduction auditory threshold,the average air bone conductance gap after operation were lower than those before operation in two groups(P<0.05).Conclusion Tympanoplasty under endotoscpe is equivalent to traditional tympanoplasty under microscope,but it has the advantages of shorter operative time,lesser trauma and hemorrhage.It is worthy of clinical promotion.