耳内镜下耳屏软骨膜夹层法鼓膜修补的临床疗效分析

Clinical analysis of myringoplasty by using sandwich method with tragus perichondrium under endoscope

目的探讨耳内镜下耳屏软骨膜夹层法鼓膜修补术的临床疗效。方法采用回顾性研究方法分析耳内镜下耳屏软骨膜夹层法修补鼓膜的80例患者,对患者术后鼓膜穿孔愈合率、鼓膜愈合形态、听力改善情况、并发症等随访至少1年。结果80例鼓膜愈合79例,愈合率为98.8%;所有鼓膜愈合形态良好;患者术前与术后1年气导平均听阈分别为(39.1±8.5)dB HL、(20.5±9.1)dB HL,差异有统计学意义(t=10.31,P<0.01);术前与术后1年平均气骨导差分别为(21.1±5.5)dB、(9.5±7.1)dB,差异有统计学意义(t=7.84,P<0.01),听力改善明显。所有病例术后均未出现严重并发症。结论耳内镜下耳屏软骨膜夹层法修补穿孔鼓膜,术后鼓膜愈合形态佳,听力恢复良好,是一种有效的手术方法,可供临床选择和推广。

OBJECTIVE To explore the clinical effect of myringoplasty by using sandwich method with tragus perichondrium under endoscope.METHODS The retrospective research method was used to analyze the clinical data of 80 patients whose perforated tympanic membrane repaired using sandwich method with tragus perichondrium under endoscope.The postoperative perforation healing rate,healing morphology of tympanic membrane,hearing improvement and postoperative complications were followed up for at least 1 year.RESULTS 79 cases of tympanic membrane was healed after surgery,the healing rate was 98.8%;all the morphrage of healed tympanic membranes were smooth with good blood supply,the average air conduction threshold of the patients before and 1 year after surgery were(39.1±8.5)dB HL and(20.5±9.1)dB HL,the difference was statistically significant(t=10.31,P<0.01);the average air-bone conduction difference before and after 1 year was(21.1±5.5)dB,(9.5±7.1)dB,the difference was statistically significant(t=7.84,P<0.01),the hearing improvement was significant.There were no complications in all cases.CONCLUSION The use of sandwich method with tragus perichondrium to repair tympanic membrane perforation is satisfying with excellent tympanic membrane morphology and hearing recovery.It's a effective surgical method and worthy of clinical recommendation.