不同厚度耳屏软骨-软骨膜复合体在治疗化脓性中耳炎继发鼓膜穿孔中的效果

Effect of different thickness of tragus cartilage-perichondrium complex in the treatment of tympanic membrane perforation secondary to suppurative otitis media

目的分析不同厚度耳屏软骨-软骨膜复合体在治疗化脓性中耳炎继发鼓膜穿孔中的效果。方法选取在我院治疗的化脓性中耳炎继发鼓膜穿孔患者168例为研究对象,按照随机数字表法分为观察组和对照组,每组84例。2组患者均接受鼓膜修补术治疗,观察组使用全厚耳屏软骨-软骨膜复合体修复材料,对照组使用半厚耳屏软骨-软骨膜复合体修复材料。观察2组患者术后外耳道形态,对比2组患者手术时间、住院时间、术中出血量、切口愈合时间及术前和术后3个月纯音听阈、疼痛视觉模拟评分法(VAS)评分、气导平均听阈、平均气骨导差,统计2组患者术后3个月并发症发生情况及术后3年复发率。结果观察组术后外耳道形态正常率显著高于对照组(P<0.05)。2组患者手术时间、住院时间、术中出血量、切口愈合时间及术前和术后3个月纯音听阈、VAS评分、气导平均听阈和平均气骨导差对比,差异均无统计学意义(P>0.05)。观察组术后3个月并发症总发生率为7.14%,显著低于对照组的23.81%(P<0.05)。随访3年,观察组总复发率为18.42%,显著低于对照组的41.10%(P<0.05)。结论鼓膜修补术中使用全厚耳屏软骨-软骨膜复合体修复材料治疗化脓性中耳炎继发鼓膜穿孔可有效重塑外耳道形态,且并发症较少,复发率较低。

Objective To analyze the effects of different thickness of tragus cartilage-perichondrium complexex in the treatment of tympanic membrane perforation secondary to suppurative otitis media.Methods A total of 168 patients with tympanic membrane perforation secondary to suppurative otitis media treated in our hospital were selected as the research objects,and they were divided into the observation group and the control group according to the random number table method,with 84 patients in each group.All patients in the two groups were treated with tympanic membrane repair,in which the observation group used the full-thickness tragus cartilage-perichondrium complex repair material,while the control group used the half-thickness tragus cartilage-perichondrium complex repair material.The postoperative morphology of external auditory canal was observed between the two groups.The operation time,hospital stay,intraoperative blood loss,wound healing time and the pure tone audiology thresholds,visual analogue scale(VAS)score,mean air conducted auditory thresholds and mean air bone gap before surgery and 3 months after surgery of the two groups were compared.The incidence of complications 3 months after surgery and the recurrence rate 3 years after surgery were analyzed.Results The normal rate of external auditory canal morphology in the observation group was significantly higher than that in the control group(P<0.05).There was no significant difference in the operation time,hospital stay,intraoperative blood loss,wound healing time,pure-tone auditory thresholds,VAS score,mean air conducted auditory thresholds,or mean air bone gap before surgery and 3 months after surgery between the two groups(P>0.05).The total incidence of complications 3 months after surgery in the observation group was 7.14%,which was significantly lower than 23.81%in the control group(P<0.05).During the 3-year follow-up,the total recurrence rate of the observation group was 18.42%,which was significantly lower than 41.10%in the control group(P<0.05).Conclusion The use of full-thickness tragus cartilage-perichondrium complex repair material in tympanic membrane repair for the treatment of tympanic membrane perforation secondary to suppurative otitis media can effectively reshape the morphology of external auditory canal with less complications and lower recurrence rate.