耳内镜下不同类型耳屏软骨—软骨膜修补鼓膜穿孔临床疗效分析

Clinical effect analysis of repairing tympanic membrane perforation with different types of tragus cartilage-perichondrium under otoendoscope

目的:探讨耳内镜下不同类型的耳屏软骨-软骨膜修补鼓膜穿孔的临床疗效。方法:选取60例(60耳)实施耳内镜手术的病人,随机分为对照组和观察组各30例,其中对照组采用全厚岛状耳屏软骨-软骨膜修补鼓膜穿孔;观察组采用半厚岛状耳屏软骨-软骨膜复合体修补鼓膜穿孔。所有病人随访6~12个月,对比分析2组鼓膜穿孔的鼓膜愈合情况及听力改善情况。结果:观察组鼓膜愈合率100.0%(30/30),高于对照组80.0%(24/30)(P<0.05)。2组术前气导听阈、气骨导差值差异均无统计学意义(P>0.05),术后观察组气导听阈、气骨导差值均明显优于对照组(P<0.01),且组内比较结果显示,术后2组气导听阈、气骨导差值均明显优于术前(P<0.01)。结论:耳内镜下耳屏软骨-软骨膜修补穿孔的鼓膜是可行的,尤其半厚岛状耳屏软骨-软骨膜复合体成活率高,可修补不同大小的鼓膜穿孔,且益于提高听力,术后听力改善效果良好。

Objective:To investigate the clinical efficacy of repairing tympanic membrane perforation with different types of tragus cartilage-perichondrium under otoendoscope.Methods:Sixty patients(60 ears)who underwent endoscopic surgery were randomly divided into the control group(n=30)and the observation group(n=30).In the observation group,the perforation of tympanic membrane was repaired by semi-thick island of tragus cartilage-perichondrium complex.All patients were followed up for 6-12 months.The healing of tympanic membrane and hearing improvement were compared between the two groups.Results:The healing rate of tympanic membrane in the observation group was 100.0%(30/30),which was higher than 80.0%(24/30)in the control group(P<0.05).There was no significant difference in the air-conductance threshold and air-bone conductance difference between the two groups before operation(P>0.05).The air-conductance threshold and air-bone conductance difference of the observation group were significantly better than those of the control group(P<0.01),and the intra-group comparison showed that the air-conductance threshold and air-bone conductance difference of the two groups after operation were significantly better than those before operation(P<0.01).Conclusions:It is feasible to repair the perforated tympanic membrane under otoendoscope,especially the semi-thick island of auricular cartilage-perichondrium complex,which has a high survival rate,can repair the perforation of tympanic membrane of different sizes,and is beneficial to improve hearing,and the postoperative hearing improvement effect is good.