耳内镜下耳屏软骨-软骨膜与颞肌筋膜在鼓膜大穿孔修补对比研究

Comparative study of auricular cartilage-perichondrium and temporalis fascia in the treatment of large perforation of the tympanic membrane with endoscope

目的探讨耳内镜下耳屏软骨-软骨膜与颞肌筋膜在鼓膜大穿孔修补术中临床应用的区别。方法回顾性分析120例(120耳)2015年1月~2018年6月于我院住院诊断为慢性中耳炎,鼓膜穿孔达50%以上,并行耳内镜下鼓膜修补术患者。将患者分为两组,耳屏软骨-软骨膜组70例(70耳)采用耳屏软骨-软骨膜修补,颞肌筋膜组50例(50耳)采用颞肌筋膜修补。分析两组患者手术时间、住院天数、术后鼓膜修补愈合率、术后气骨导差的变化等,分析比较耳屏软骨-软骨膜与颞肌筋膜在鼓膜大穿孔修补中的效果与价值。结果耳内镜下A组手术时间比B组明显缩短,术中出血量明显减少,住院天数明显缩短,且两组鼓膜愈合率和听力改善无明显差异。结论耳屏软骨-软骨膜在耳内镜下鼓膜大穿孔修补术中较颞肌筋膜有着较好的应用前景。

OBJECTIVE To investigate the difference between auricular cartilage-perichondrium and temporalis fascia in the treatment of large perforation of the tympanic membrane with endoscope.METHODS A retrospective analysis of 120 cases (120 ears) of patients diagnosed with chronic otitis media in our hospital from January 2015 to June 2018 was conducted.All of patients were required to have large tympanic membrane perforation of more than 50%,and underwent endoscopic myringoplasty.These patients were divided into two groups.In group A,70 patients (70 ears) were treated with auricular cartilage-perichondrium;while in group B,50 patients (50 ears) were treated with temporalis fascia.By comparing the operation time,hospital stay,tympanic membrane healing rate and changes of air bone gap between the two groups,the effects and value of auricular cartilage-perichondrium and temporalis fascia in the repair of tympanic membrane large perforation were compared.RESULTS The operation time of group A was significantly shorter than that of the group B.The intraoperative blood loss was significantly reduced in Group A,and the hospital stay were significantly shortened.There was no significant difference in the healing rate between the two groups.CONCLUSION The auricular cartilage-perichondrium has a better prospect than the temporalis fascia in the treatment of large tympanic membrane perforation under endoscope.