耳内镜下鼓膜修补术治疗中耳炎鼓膜穿孔的疗效观察

Observation on the Therapeutic Effect of Tympanic Membrane Repair under Ear Endoscopy with Tympanic Membrane Perforation Caused by Otitis Media

目的分析耳内镜下鼓膜修补术治疗中耳炎鼓膜穿孔患者对其纯音听阈、并发症发生率的影响及疗效观察。方法选取2019年12月至2023年12月德江县人民医院耳鼻喉科收治的中耳炎鼓膜穿孔患者68例,根据手术方法的不同分为观察组和对照组,各34例。观察组给予耳内镜下鼓膜修补术,对照组给予显微镜下鼓膜修补术,比较两组手术操作时间、术中出血量、鼓膜愈合率、干耳率、纯音听阈、并发症发生率、生活质量。结果观察组手术操作时间短于对照组,术中出血量低于对照组,鼓膜愈合率和干耳率均高于对照组,差异有统计学意义(P<0.05);两组治疗3个月和治疗6个月气导听阈、骨导听阈、气骨导差比较,差异无统计学意义(P>0.05);对照组和观察组并发症发生率分别为14.71%(5/34)和0.00%(0/34);术后两组耳部症状、主观听力水平、心理情况、医疗资源使用评分均显著降低,观察组低于对照组,差异有统计学意义(P<0.05)。结论耳内镜下鼓膜修补术提高改善纯音听阈,且安全性良好,是治疗中耳炎患者的良好外科手术方法。

Objective To analyze the effect of tympanic membrane repair under the ear endoscope on pure tone threshold,incidence of complications,and efficacy in patie nts with chronic otitis media(COM)tympanic mem-brane perforation.Methods The study included 68 patients with COM tympanic membrane perforation treated at the Department of Otolaryngology of Jiang County People's Hospital from December 2019 to December 2023.According to different surgical methods,they were divided into the observation group and the control group,with 34 cases in each group.The observation group underwent tympanic membrane repair under the ear endoscope,while the control group underwent tympanic membrane repair under the microscope.The surgical operation time,intraoperative blood loss,tympanic membrane healing rate,dry ear rate,pure tone threshold,incidence of complications,and quality of life were compared between the two groups.Results In the observation group,the operation time was shorter than that in the control group,the intraoperative blood loss was lower than that in the control group,and the tympanic membrane healing rate and dry ear rate were higher than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in air-conduction threshold,bone-conduction threshold,and air-bone gap between the two groups at 3 and 6 months after treatment(P>0.05).The incidence of complications in the control group and the obs ervation group was 14.71%(5/34)and 0.00%(0/34),respectively.After surgery,the ear symptoms,subjective hearing level,psychological status,and medical resource utilization scores in both groups were significantly reduced,while the observation group showing lower scores than the scores of control group,and statistically significant differences(P<0.05).Conclusion Tympanic membrane repair under the ear endoscope can improve pure tone threshold,is safe,and is a good surgical method for treating patients with COM.