耳内镜下应用耳屏软骨-软骨膜复合体行Ⅰ鼓室成型术的效果研究

Study on the Effect of Tympanoplasty with Tragus Cartilage-perichondrial Complex under Otoscope

目的患者在耳内镜下使用耳屏软骨-软骨膜复合体行Ⅰ鼓室成型术进行治疗,对该手术的治疗效果进行研究分析。方法选择该院在2018年6月-2020年1月期间收治的60例行Ⅰ鼓室成型术患者,以随机数字表法作为分组原则,分成30例观察组和30例对照组,其中观察组的治疗方法为耳内镜下治疗,对照组的治疗方法为显微镜下治疗,比较两种镜下的手术指标,比较两组患者的术后1年的气导听阈以及气骨导差改善情况。结果观察组患者的手术时间(26.94±9.08)min、住院时间(4.30±1.82)d短于对照组患者,术中出血量(4.03±1.64)mL少于对照组患者,差异有统计学意义(t=6.887、4.421、11.756,P<0.05);术前,两组患者气导听阈以及气骨导差比较,差异无统计学意义(t=0.384、0.368,P>0.05),术后1年,两组患者气导听阈以及气骨导差均发生改善,观察组患者的术后气导听阈(31.86±4.82)dB、气骨导差(16.52±3.46)dB低于对照组,差异有统计学意义(t=5.476、5.323,P<0.05)。结论在耳内镜下使用耳屏软骨-软骨膜复合体行Ⅰ鼓室成型术对患者进行治疗,可以显著提高治疗效果,改善术中相关指标。

Objective The patient underwent tympanoplasty with tragus cartilage-perichondrial complex under an ear endoscopy to study and analyze the therapeutic effect of this operation.Methods Sixty patients undergoing tympanoplasty in the hospital between June 2018 and January 2020 were selected.The random number table method was used as the grouping principle and divided into 30 observation group and 30 control group.Among them,the observation group adopted otoscope treatment,and the treatment method of the control group was treatment under a microscope.The two surgical indicators under the microscope were compared,and the air conduction hearing threshold and the improvement of air conduction hearing threshold and air bone conduction difference of the two groups were compared at 1 year after surgery.Results The operation time(26.94±9.08)min and hospitalization time(4.30±1.82)d of the observation group were shorter than those of the control group,and the intraoperative blood loss(4.03±1.64)mL was less than that of the control group.The difference was statistically significant(t=6.887,4.421,11.756,P<0.05);before operation,there was no significant difference in air conduction hearing threshold and air-bone conduction difference between the two groups of patients(t=0.384,0.368,P>0.05),1 year after operation of the air conduction hearing threshold and air-bone conduction difference of the two groups were improved.The postoperative air conduction hearing threshold(31.86±4.82)dB and air-bone conduction difference(16.52±3.46)dB of the observation group were lower than those of the control group,and the difference was statistically significant,with academic significance(t=5.476,5.323,P<0.05).Conclusion The use of tragus cartilage-perichondrial complex to treat patients with tympanoplasty under otoscope can significantly improve the treatment effect and improve intraoperative related indicators.