耳内镜下鼓室成形术对慢性中耳炎伴有鼓膜穿孔患者听力水平的影响

Effect of endoscopic tympanoplasty on hearing level in patients with chronic otitis media accompanied by tympanic membrane perforation

目的 研究耳内镜下鼓室成形术对慢性中耳炎伴有鼓膜穿孔患者听力水平的影响。方法 采用回顾性分析方法,选取2019年1月至2021年6月亳州市人民医院收治的90例慢性中耳炎伴有鼓膜穿孔患者作为研究对象,按照治疗方式不同分为研究组(n=45)与对照组(n=45),研究组行耳内镜下鼓室成形术治疗,对照组行传统手术治疗。比较两组患者手术前后气骨导差、气导听阈、生活质量评分与治疗总有效率、干耳率、复发率和并发症(耳廓麻木、疼痛、切口感染、血肿)发生率。结果 术前,两组患者气骨导差、气导听阈、生活质量评分比较,差异均无统计学意义(P>0.05)。术后,两组患者气骨导差、气导听阈均明显低于治疗前,生活质量评分均明显高于治疗前,且研究组患者气骨导差、气导听阈明显低于对照组,生活质量评分明显高于对照组,差异均有统计学意义(P<0.05)。研究组患者术后总有效率为97.78%,明显高于对照组(82.22%),差异有统计学意义(P<0.05)。研究组患者术后干耳率为95.56%,明显高于对照组(80.00%),复发率为2.22%,明显低于对照组(20.00%),差异均有统计学意义(P<0.05)。两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论 耳内镜下鼓室成形术治疗慢性中耳炎伴有鼓膜穿孔患者的疗效显著,可有效促进患者听力水平快速恢复,提升干耳率,减少复发率,提升其生活质量,且并发症少,安全性高。

Objective To study the effect of ear endoscopic tympanoplasty on the hearing level of patients with chronic otitis media accompanied by tympanic membrane perforation.Methods Using a retrospective analysis method,90 patients with chronic otitis media and tympanic membrane perforation who were admitted to Bozhou People's Hospital from January 2019 to June 2021 were selected as the research objects.According to different treatment methods,they were divided into study group(n=45)and control group(n=45).The study group was treated with endoscopic tympanoplasty,and the control group was treated with traditional surgery.The air-bone conduction difference,air-conduction hearing threshold,quality of life score,total effective rate,dry ear rate,recurrence rate and incidence of complications(auricular numbness,pain,incision infection,hematoma)were compared between the two groups before and after surgery.Results Before surgery,there was no significant difference in air-bone conduction,air-conduction hearing threshold and quality of life scores between the two groups(P>0.05);after surgery,air-bone conduction difference,air-conduction hearing threshold and quality of life scores of the two groups were significantly lower than those before surgery and the quality of life scores were significantly higher than those before surgery,and the air-bone conduction difference,air-conduction hearing threshold of the study group were significantly lower than those of the control group,and the quality of life score was significantly higher than that of the control group,and the differences were statistically significant(P<0.05).The total effective rate of patients in the study group was 97.78%,which was significantly higher than that in the control group(82.22%),and the difference was statistically significant(P<0.05).The postoperative dry ear rate of patients in the study group was 95.56%,which was significantly higher than that in the control group(80.00%),and the recurrence rate was 2.22%,which was significantly lower than that in the control group(20.00%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Endoscopic tympanoplasty has significant curative effect in the treatment of chronic otitis media with perforation of the tympanic membrane.It can effectively promote the rapid recovery of hearing level,increase the dry ear rate,reduce the recurrence rate,and improve the quality of life,with fewer complications and high safety.