耳内镜下耳屏软骨膜修补鼓膜大穿孔的临床疗效分析

Clinical analysis of using tragus perichondrium under otoscope to repair large perforation of tympanic membrane

目的 探讨耳内镜下耳屏软骨膜在鼓膜大穿孔修补中的临床疗效。方法 回顾性分析2018年1月~2021年9月行耳内镜下耳屏软骨膜修补鼓膜大穿孔病例70例,对术后鼓膜穿孔愈合率、鼓膜愈合形态、听力改善情况随访至少1年。结果 夹层法病例术前与术后1年气导听阈分别为(53.54±2.18)dB HL、(38.62±2.24)dB HL;气骨导差分别为(35.53±2.31)dB HL、(17.06±2.36)dB HL,差异有统计学意义(P<0.01)。内置法病例术前与术后1年气导听阈分别为(51.76±6.02)dB HL、(35.83±4.61)dB HL;气骨导差分别为(32.65±6.72)dB HL、(15.86±5.19)dB HL,差异有统计学意义(P<0.01)。结论耳内镜下耳屏软骨膜修补大穿孔鼓膜,术后鼓膜穿孔愈合率高,愈合形态出色,听力恢复良好,是一种有效的手术方法,熟练掌握后可供临床选择和推广。

OBJECTIVE To investigate the clinical effect of using tragus perichondrium under otoscope to repair large perforation of tympanic membrane.METHODS Seventy patients with large perforation of tympanic membrane repaired by tragus perichondrium under otoscope from January 2018 to September 2021 were retrospectively analyzed.The healing rate of tympanic membrane,healing shape of tympanic membrane and hearing improvement were followed up for at least one year.RESULTS The average air conduction hearing threshold of overlay method cases before and 1 year after surgery was(53.54±2.18)dB HL and(38.62±2.24)dB HL,respectively;The average air bone conduction differences were(35.53±2.31)dB HL and(17.06±2.36)dB HL,respectively with statistically significant differences(P0.01).The average air conduction hearing threshold of patients with underlay method before and 1 year after surgery was(51.76±6.02)dB HL and(35.83±4.61)dB HL,respectively;The average air bone conduction differences were(32.65±6.72)dB HL and(15.86±5.19)dB HL,respectively with statistically significant differences(P0.01).CONCLUSION Endoscopic repair of large perforated tympanic membrane with tragus perichondrium is an effective surgical method with high healing rate,excellent healing shape and good hearing recovery.It can be used for clinical selection and promotion after mastering it skillfully.