应用耳屏软骨与软骨膜复合体行耳内镜下修补鼓膜术的效果

Effect of Endoscopic Tympanoplasty with The Compound of Cartilage and Perichondrium of Tragus

目的:观察应用耳屏软骨与软骨膜复合体行耳内镜下修补鼓膜术的临床治疗效果。方法:将2015年1月-2018年11月我院收治的139例(139耳)行修补鼓膜术患者根据手术方式分为两组,观察组应用耳屏软骨与软骨膜复合体行耳内镜下修补鼓膜术,共73例(73耳),对照组应用颞肌筋膜行显微镜下修补鼓膜术,共66例(66耳)。比较2组患者手术需要时间、术中失血量及住院天数,术后随访6个月,观察比较两组鼓膜愈合率、气导听阈及气骨导差的变化。结果:与对照组比较,观察组患者手术需要时间、术中失血量及住院天数均明显降低,鼓膜愈合率明显升高,差异均有显著性(P<0.05)。治疗后两组气导听阈、气骨导差均较治疗前有明显的好转,差异均有显著性(P<0.05);观察组治疗后气导听阈、气骨导差改善较对照组更加明显,差异均有显著性(P<0.05)。结论:应用耳屏软骨与软骨膜行耳内镜下鼓膜修补穿孔可以明显的改善患者听力,手术用时较短、对患者的创伤更小,临床进行广泛推广的价值较高。

Objective:To observe the clinical effect of repairing tympanic membrane with the compound of Tragus Cartilage and perichondrium.Method:From January 2015 to November 2018,139 cases(139 ears)of tympanoplasty in our hospital were divided into two groups according to the operation mode.In the observation group,73 cases(73 ears)of tympanoplasty were performed with the combination of cartilage and cartilage membrane of the tragus.In the control group,66 cases(66 ears)of tympanoplasty were performed with the temporalis myofasciae.The time needed for operation,blood loss during operation and the days of hospitalization were compared between the two groups.The patients were followed up for 6 months after operation.Result:Compared with the control group,the time needed for operation,blood loss during operation and hospital stay in the observation group were significantly reduced,and the healing rate of tympanic membrane was significantly increased(P<0.05).After treatment,the thresholds and differences of the two groups were significantly improved(P<0.05);after treatment,the thresholds and differences of the two groups were significantly improved(P<0.05).Conclusion:The application of Tragus Cartilage and perichondrium to repair perforation of tympanic membrane under otoendoscopy can significantly improve the hearing of patients,the operation time is shorter,the trauma of patients is smaller,and the clinical value of extensive promotion is higher.