耳内镜和显微镜下鼓室成形术的临床观察比较

Clinical Observation and Comparison of Endoscopic and Microscopic Tympanoplasty

目的:比较耳内镜和显微镜下Ⅰ、Ⅱ型鼓室成形术的疗效。方法:回顾2016年1月-2018年12月于笔者所在科室行Ⅰ、Ⅱ型鼓室成形术的患者81例,按手术方式分为两组,一组耳内镜下行Ⅰ、Ⅱ型鼓室成形术(耳内镜组),共31例,另一组显微镜下行Ⅰ、Ⅱ型鼓室成形术(显微镜组),共50例。比较两组手术时间,术后3个月鼓膜愈合情况。结果:耳内镜组平均手术时间为(73.5±14.2)min,短于显微镜组的(87.0±12.5)min,差异有统计学意义(P<0.01);术后3个月耳内镜组鼓膜愈合率为96.7%,显微镜组为96.0%,差异无统计学意义(P>0.05)。结论:耳内镜下行Ⅰ、Ⅱ型鼓室成形术可以获得与显微镜相当的愈合率,但其手术时间更短,值得一定范围内临床推广。

Objective: To compare the efficacy of endoscopic and microscopic tympanoplasty type Ⅰ and Ⅱ. Method: This was a retrospective study including 81 cases of patients who received typeⅠ, Ⅱ tympanoplasty from January 2016 to December 2018. The patients were divided into two groups according to the mode of operation. One group was treated with endoscopy with typeⅠ and typeⅡ tympanoplasty(the endoscopy group), with 31 cases, and the other group was treated with microscope with typeⅠ and typeⅡ tympanoplasty(the microscope group), with 50 cases. The operation time and tympanic membrane healing 3 months after operation were compared between the two groups. Result: The average operation time of the endoscopy group was(73.5±14.2) min, which was significantly shorter than(87.0±12.50) min of the microscope group, the difference was statistically significant(P<0.01). The healing rate was 96.7% in the endoscopy group and 96.0% in the microscope group 3 months after surgery, and the difference was not statistically significant(P>0.05). Conclusion: Tympanoplasty of typeⅠ and type Ⅱ under otoendoscopy can achieve good healing rate and short operation time, which is worthy of clinical promotion in a certain range.