耳道全耳内镜下应用不同材料修补鼓膜对鼓膜穿孔患者预后的影响

Effects of using different materials to repair the tympanic membrane under total transcanal endoscope on the prognosis of patients with tympanic membrane perforation

目的:研究耳道全耳内镜下应用不同材料修补鼓膜对鼓膜穿孔患者预后的影响。方法:选取2020年1月至2023年6月期间上犹县人民医院收治的70例鼓膜穿孔患者。采用随机数字表法分为全厚软骨组35例和半厚软骨组35例。全厚软骨组厚度为1 mm,半厚软骨组为0.5 mm,两组均实施耳道全耳内镜下鼓膜修补术。比较两组手术情况(手术时间、术中出血量、耳屏愈合时间)、术前及术后3 m听力水平及疼痛视觉模拟评分(Visual Analogue Scale,VAS)、术前及术后3 m气导平均听阈及平均气骨导差及术后并发症发生率。结果:两组手术时间、术中出血量及耳屏愈合时间比较无明显差异(P<0.05);两组术前及术后3 m的纯音听阈及VAS评分比较无差异(P<0.05);两组术前及术后3 m的气导平均听阈及平均气骨导差比较无差异(P<0.05);全厚软骨组并发症发生率为5.71%,半厚软骨组为22.86%,全厚软骨组明显低于半厚软骨组(P<0.05)。结论:耳道全耳内镜下应用不同材料修补鼓膜对鼓膜穿孔均可以有效改善患者手术情况、术后听力水平和疼痛评分,但全厚耳屏软骨-软骨膜复合体术后并发症较少。

Objective:To study the effects of using different materials to repair the tympanic membrane under total transcanal endoscope on the prognosis of patients with tympanic membrane perforation.Methods:70 patients with tympanic membrane perforation who were admitted to People's Hospital of Shangyou County from January 2020 to June 2023 were enrolled in this study.They were divided into the full-thickness cartilage group(35 cases)and the half-thickness cartilage group(35 cases)by the random number table method.The thickness of the full-thickness cartilage group was 1 mm,and the thickness of the half-thickness cartilage group was 0.5 mm.Both groups underwent total transcanal endoscopic myringoplasty.The two groups were compared on surgical conditions(surgical time,intraoperative blood loss and tragus healing time),hearing levels,Visual Analogue Scale(VAS)scores,average air conduction hearing thresholds and average air-bone conduction gaps before surgery and at 3 months after surgery,and the incidence of postoperative complications.Results:There was no statistically significant difference in surgical time,intraoperative blood loss,or tragus healing time between the two groups(P>0.05).There was no statistically significant difference in pure tone hearing threshold or VAS score between the two groups before surgery and at 3 months after surgery(P>0.05).There was no statistically significant difference in average air conduction hearing threshold or average air-bone conduction gap between the two groups before surgery and at 3 months after surgery(P>0.05).The incidence of complications in the full-thickness cartilage group(5.71%)was significantly lower than that in the half-thickness cartilage group(22.86%)(P<0.05).Conclusion:Using different materials to repair the tympanic membrane under total transcanal endoscope can effectively improve surgical condition,postoperative hearing level,and pain score of patients with tympanic membrane perforation.However,there are fewer complications after repair with tragus cartilage-perichondrium complex.