Interlayer repair with porcine small intestinal submucosa versus internal repair with tragus cartilage in endoscopic tympanoplasty

Objective Endoscopic tympanoplasty includes various surgical methods,such as internal repair,interlayer repair,and external overlay.This technique requires autologous materials,allografts,and xenografts,which are used to repair tympanic membrane(TM)perforation.To obtain good results,appropriate surgical methods and repair materials should be selected.This study aims to assess the efficacy of repairing refractory TM perforations in the porcine small intestinal submucosa(SIS)during transcanal endoscopic type I tympanoplasty.Method A retrospective chart review was performed on patients who underwent TM perforation repair with porcine SIS and tragus cartilage between January 2022 and September 2022 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Perforation size,tympanic status,pre-and postoperative symptoms,follow-up data,wound healing rates,and hearing improvement were analysed.Results Of the 115 patients included in the study,56 underwent interlayer repair with porcine SIS of the TM,and 59 patients underwent internal repair with tragus cartilage.No significant difference was found between the two groups at baseline in terms of age,sex,disease course,perforation side,tympanic status,underlying disease,or preoperative infection.The total postoperative effective rate of interlayer implantation with porcine SIS was 91.07%(51 patients),and that of internal implantation with tragus cartilage was 88.14%(52 patients).No significant difference was found in terms of the graft success rate between the two surgical methods(p=0.887).Postoperative pure tone auditory(PTA)and air-bone gap(ABG)density significantly increased in both groups compared with before surgery(p<0.05).However,the postoperative PTA and ABG density were not significantly different 3 months post-surgery between the two groups(p>0.05).Compared to those in the internal implantation group,the patients in the interlayer group had a shorter operation duration(51.36±6.76 min vs.59.71±7.45 min,t=6.298,p<0.001)and less blood loss(11.91±2.61 mL vs.15.27±2.57 mL,t=7.019,p<0.001).Conclusions Our study suggests that the porcine SIS,as well as the tragus cartilage,has a high success rate in repairing irreversible TM perforation.Endoscopic tympanoplasty via interlayer implantation with porcine SIS offers distinct advantages,including the absence of donor-site incision and scar formation,and ease of graft modification and manipulation.

Endoscopic push through tragal cartilage tympanoplasty: A 10-year retrospective review of our technique and outcomes

BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.

外耳道袖套皮瓣+舌状筋膜瓣技术在鼓膜重建中的应用

目的研究外耳道袖套皮瓣-舌状筋膜瓣技术修复鼓膜大穿孔的应用价值。方法回顾性选取2020年6月至2024年6月在北京大学国际医院施行的袖套-舌形瓣鼓室成形手术患者73例,穿孔面积占鼓膜截面积50%~75%的大穿孔66例,穿孔面积大于鼓膜截面积75%的特大穿孔7例,观察患者的鼓膜愈合情况与手术前-后听力学指标。结果应用该技术重建鼓膜的愈合率达94.52%(69/73例),术后纯音测听(pure tone audiometry,PTA)较前提高,PTA提升中位数8.75(1.25,16.25)dB;术后气骨导差(air-bone gap,ABG)较术前缩小,ABG缩小中位数7.5(0.63,13.75)dB。鼓膜大穿孔和特大穿孔的愈合率无显著性差异(P=0.338)。结论外耳道袖套皮瓣-舌形筋膜瓣技术兼顾了局部血运、耳道成形、鼓膜形态以及与耳道的解剖关系,显现出良好的鼓膜愈合率和听力学改善,为临床复杂鼓膜的重建提供了一种新选择。

Endoscopic tympanoplasty

Middle ear surgery is usually performed using a surgical microscope. Initially, in otorhinolaryngology practice, endoscopes were used for paranasal sinus surgeries. It was only later that they were applied in the area of otology. In otologic surgeries, endoscopes were first used to visualize the middle ear, before being used to assist with visualization of instruments during cholesteatoma surgeries, although they are still not used alone in various otologic surgeries. As in other surgical fields, there is also a trend towards minimally invasive intervention in the field of otorhinolaryngology. Smaller incisions performed under the guidance of endoscopes are preferred over conventional large incisions. Using this approach, improved outcomes can be achieved and postoperative morbidities can be reduced. In addition, the outcomes of grafts performed using the endoscopic approach are similar to that achieved by the microscopic approach. Therefore, endoscopic ear surgery implementations are becoming increasingly popular.

A comparative study of sequential vs.simultaneous type Ⅰ tympanoplasty in patients with bilateral chronic otitis media-Mucosal type

Background:Patients with bilateral chronic otitis media-mucosal type have been conventionally treated with sequential tympanoplasty.Bilateral simultaneous tympanoplasty is usually not preferred because of the theoretical risk of iatrogenic sensorineural hearing loss.With the advent of modern surgical instruments and surgical techniques,the risk is expected to be lower.This study compares the clinical outcomes in typeⅠtympanoplasty performed simultaneously and sequentially.Materials&methods:This randomized prospective study was carried out in a tertiary care hospital between August 2015 and July 2017.A total of 30 patients were divided into two groups of 15 each.This study analyzed the graft uptake,pure tone audiogram findings pre-and post-operatively,duration of surgery and number of hospital visit for each patient and the outco mes were co mpared between both the groups.Result:Patients undergoing bilateral simultaneous tympanoplasty had significantly lesser mean duration of surgery and number of hospital visits than the patients undergoing sequential tympanoplasty.Graft uptake and postoperative wound infections were similar in both the groups.Postoperative hearing improvement was significantly better in the bilateral simultaneous tympanoplasty group.However,further studies are needed to authenticate this observation.None of the patients had a postoperative deterioration of hearing or sensorineural hearing loss.Conclusion:Bilateral simultaneous tympanoplasty is not only feasible but also better than sequential tympanoplasty,especially in terms of operating time,follow-up and overall financial implications on the patient.

Success rates for various graft materials in tympanoplasty e A review

Objectives:The aim of this paper is to review how successful each type of grafts is in tympanoplasty.Methods:Pubmed,Google and the Proquest Central Database at Kırıkkale University were queried using the keywords“graft”,“success”“tympanoplasty”,“success rate”with the search limited to the period 1955 to 2017.Results:Various types of graft materials including temporalis fascia,cartilage,perichondrium,periosteum,vein,fat or skin have been used in the reconstruction of tympanic membrane(TM)perforation.Although temporalis fascia ensures good hearing is restored,there are significant concerns that its dimensional stability characteristics may lead to residual perforation,especially where large TM perforations are involved.The“palisade cartilage”and“cartilage island”techniques have been stated to increase the strength and stability of a tympanic graft,but they may result in a less functional outcome in terms of restoring hearing.Smoking habits,the size and site of a perforation,the expertise level of the operating surgeon,age,gender,the status of the middle ear mucosa and the presence of myringosclerosis or tympanosclerosis are all important in determining how successful a graft is.Conclusion:Although temporal fascia is the most commonly used graft material for tympanoplasty,poor graft stability may cause failure.This failure is due to the inclusion of connective fibrous tissue containing irregular elastic fibers present in the grafted fascia.Cartilage grafts offer better ability to resist infection,pressure,and cope with insufficient vascular supply.This means that cartilage grafts are suitable for use in revision cases.

Canal Wall down Mastoidectomy and Tympanoplasty in Cholesteatoma Surgery: Ten Years’ Experience

Tympanomastoid surgery for cholesteatoma is a procedure designed to eliminate the disease and maintain a safe and dry ear. This retrospective study was designed to evaluate the functional results of cholesteatoma patients who underwent canal wall down mastoidectomy in conjunction with a tympanoplasty. Operated ears due to chronic otitis media with cholesteatoma were considered for the study. The study was carried out in 120 ears. The choice of technique for tympanoplasty is based on the pathology encountered in the stapes superstructure. Patients were divided into three: 1) Group A, a type II TPL with stapes columella reconstruction;2) Group B, a type III TPL with major columella reconstruction;and 3) Group C, a type IV TPL using a temporalis fascia and thick cartilage to shield the round window. The operated ears of Groups A and B, as compared to Group C, presented a significant decrease in the pre-operative Air-bone gap and an increase in the number of operated ears with an Air-bone gap between 0 - 20 dB. The study emphasizes the importance of functional separation of the two acoustic windows by fascia and cartilage graft when the stapes superstructure is missing but the footplate is mobile.

EXPERIENCE WITH OVERLAY TYMPANOPLASTY IN 83 CHINESE PATIENTS

Background In many European and American hospitals, represented by the House Ear Clinic (HEC), the overlay tympanoplasty is used with rare exception, with simultaneous canal wall up or down mastoidectomy being taken if needed. In China, underlay tympanoplasty is used across the country, but the overlay tech-nique is used rarely. The aim of the current study was to report the authors’experience with overlay tympa-noplasty in 83 Chinese patients and study its value. Methods Eight-three patients (86 ears) underwent over-lay tympanoplasty in accordance to the standard of the HEC. The patients were followed up and conditions of the external auditory canal, tympanic membrane and hearing were reviewed and analyzed. Results All patients gained stage I incision healing. The size of external auditory canal and tympanic membrane mor-phology were satisfactory. Hearing either remained unchanged or improved. There were no hearing deterio-ration or serious complications. Conclusions Overlay tympanoplasty carries positive value in treating chron-ic otitis media and cholesteatoma with the merits of procedure standardization, adequate operative exposure, thorough disease elimination and extensive adaptation.

Radical mastoidectomy and primary tympanoplasty under microscopy correlation analysis of therapeutic efficiency of hearing reconstruction

Objective The aim of this article is to research the radical mastoidectomy and primary tympanoplasty to attain radical cure of the mastoid focus as well as rebuilding the sound-conducting structure of the tympanic cavity to improve the audition. Method The autobone and temporal fascia were taken as the transplants after the radical mastoidectomy under microscopy, and then to carry out the operation of Portmann`s tempanoplasty of 2nd and 3rd types of 2nd class.Result Non of the cholesteatoma was relapsed after follow-up for 1～4 years.The efficiency rate of tympanoplasty is of 89.47%.The average audition increased was 19 dB HL. Conclussion Radical operation for cholesteatoma should be associated with tympanoplasty if having condition. We recommend that the opening tympanoplasty should be used, and use autobone as a artificial auditory ossicles.

Success rates and predictors of outcomes of type I tympanoplasty performed by residents in a teaching tertiary hospital

Several technical variations of tympanoplasty have been reported,usually involving the type of graft and/or instruments used.Few studies have focused on the outcome of type-1 tympanoplasty specifically in teaching scenarios.We aimed to describe the results of type-1 tympanoplasty performed by residents,and to investigate potential predictive factors of surgical success.To do so,we did a retrospective analysis of medical records of patients who underwent type-1 tympanoplasty in a tertiary university hospital.We evaluated the tympanic membrane closure and audiometric outcomes during the first year of follow-up,and compared the results according to some clinical and surgical factors.130 operated ears were included in the study.The closure rate reached 84.12%after one month and 72.72%after twelve months of surgery.The mean air-bone gap was 22.98 dB preoperatively,and reached 10.55 dB after surgery.Perforation closure rates were 85%and 57.14%for those operated by endoscopic and microscopic-assisted approaches,respectively(p?0.004).The use of cartilage grafts and time without otorrhea of more than three months prior to surgery were also predictors of surgical success(p?0.002 and 0.041,respectively).Gender,age,perforation size,contralateral disease,operated side,reoperation,and degree of hearing loss did not significantly interfere with outcomes.Tympanoplasty showed good overall results when performed by residents,although inferior to those reported by experienced surgeons.The use of the endoscope,cartilage grafting,and longer preoperative time without otorrhea were predictors of surgical success in this scenario.

Long-term results of type I tympanoplasty with perichondrium reinforced cartilage palisade vs temporalis fascia for large perforations:A retrospective study

Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforations over 5 years follow-up period.Materials and methods:This was a retrospective comparative study involving patients with chronic otitis media with large TM perforations.The patients underwent type I tympanoplasty using either perichondrium reinforced cartilage palisade(CP group)or temporalis fascia(TF group)as the graft via a transmeatal approach and under local anesthesia.Morphological and functional results were recorded at three-and five years follow-up.Demographic profiles including age and sex,surgery side,contralateral disease and graft uptake rate,as well as hearing outcomes,were compared between the two groups.Results:At three years follow-up,graft uptake was 94.87%for perichondrium reinforced cartilage palisade and 80.7%for fascia,respectively,(p¼0.67).At five years follow-up,the uptake rate dropped to 87.17%in the CP group,but to 66.6%in the TF group(p¼0.019).Hearing improved after surgery in both groups,and showed no significant difference between the two groups.Conclusion:Over long-term,perichondrium reinforced palisade showed a statistically significant better outcome regarding graft uptake than temporalis fascia in type Itympanoplasty for large TM perforations with comparable audiometric results.

Prolonged Middle Ear Ventilation by Cartilage-Grommet Tympanoplasty

In 1994, the American Otological Society reported favourable experience with composite cartilage shield tympanoplasty. The tragal cartilage with a grommet inserted in it was used for tympanoplasty in our patient with unilateral CSOM, supposedly because of severe chronic eustachian tube dysfunction. The marriage of cartilage tympanoplasty with grommet insertion was aimed to add the advantages and abolish the disadvantages of both the procedures. In 1990 Lary Hall first introduced the “long term ventilation of the middle ear” with a T-tube placed in the tragal cartilage perichondrium composite island graft. T-tube insertion in the cartilage has been described. But insertion of the Indian Sheperds grommet (ventilation tube) in the cartilage graft as described in this case and its technique are possibly the first of its kinds in literature. The report is aimed to ignite innovation of newer and better techniques of cartilage tympanoplasty.

Triple-c Cartilage Tympanoplasty: Case Series

The triple-c cartilage tympanoplasty i.e. (composite chondroperichondrial clip) technique was devised by Fernandes in 2003. Objectives: The objective of our case series was to assess the success rate and efficacy of the triple-c cartilage tympanoplasty by transcanal approach. Study Design: A retrospective analysis of patients subjected to the technique was conducted. Methods: 20 cases who met the inclusion criteria were assessed by otomicroscopy and pure tone audiometry before and 2 months after the surgery. Results: All patients had complete take-up of the graft and a hearing improvement which was statistically significant. Conclusions: Thus the triple-c technique provides an effective method of closing nonmarginal perforations of the tympanic membrane.

Comparison of tragal perichondrium and COOK artificial material in endoscopic type 1 tympanoplasty

Objective:Various materials have been used for tympanic membrane reconstruction in middle ear surgery.This study aimed to evaluate the difference between the tragal perichondrium and COOK arti-ficial material in patients who underwent endoscopic type 1 tympanoplasty.Method:This retrospective study included patients who underwent endoscopic type 1 tympanoplasty from June 2021 to June 2022 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Patients were divided into group A(tragal perichondrium)and group B(COOK artificial material)ac-cording to the material used in the operation.All patients were followed up for 6 months.The differences in age,gender,operation site,disease course,preoperative air-bone gap(ABG),operation time,blood loss,hearing gain,and wound healing rate were compared between the two groups.Results:This study enrolled 197 patients,with 120 patients in group A and 77 patients in group B.There were no significant differences in age,gender,operation site,disease course,or preoperative ABG be-tween groups A and B(p>0.05).Both groups had significant postoperative improvement in hearing(group A:30.98±9.58 dB vs.17.07±9.92 dB,p<0.001;group B:29.75±7.52 dB vs.14.25±9.07 dB,p<0.001).The mean hearing gain in group A and group B was comparable(14.02±11.91 dB vs.15.50±7.05 dB,p=0.609).The wound healing rates of groups A and B were no differences(93.33%vs.87.01%,p=0.133).The patients in group B had a shorter operation duration(72.57±11.32 min vs.61.86±9.27 min,p=0.045)and less blood loss(12.38±3.7 mL vs.8.10±2.43 mL,p=0.004).Conclusions:Tragal perichondrium and COOK artificial material are reliable for functional and anatomical outcomes in endoscopic type 1 tympanoplasty,and COOK artificial material can save operation time and blood loss in surgery compared to the tragal perichondrium.

Comparison of endoscopic tympanoplasty to microscopic tympanoplasty in anterior tympanic membrane perforation

Objective:Tympanoplasty aims to eradicate lesions and restore middle ear function in chronic otitis media.This study was conducted to compare the surgical and functional outcomes of endoscopic tympanoplasty(ET)and microscopic tympanoplasty(MT)in anterior tympanic membrane perforation.Methods:The clinical data of 42 patients undergoing tympanoplasty with anterior quadrants tympanic membrane perforation between January 2018 and July 2019 were retrospectively analyzed.Patients were classified into the ET group(n?22)or the MT group(n?20).Patients’demographics,clinical characteristics,surgical and functional outcomes were assessed between the two groups.Results:External auditory canal widening was not necessary in the ET group and was performed in 55.0%of patients in the MT group.The operation time of the ET group was significantly shorter than that of the MT group(61.23±11.48 min vs.78.65±11.79 min,p=0.034).The pain scale score of the ET group at 24 hours after surgery was significantly lower than that of the MT group(0.86±0.64 vs.2.40±1.14,p=0.029).The grafting success rate was 95.5%(21/22)in the ET group and 95.0%(19/20)in the MT group.In the ET group,the pre-and postoperative air-bone gap were 35.60±8.43 dB and 18.79±5.80 dB,respectively,which was a significant improvement(p=0.016).The respective values in the MT group(33.33±7.88 dB and 19.58±6.24 dB)also represented a significant improvement(p=0.004).Conclusion:ET is more beneficial for patients with anterior tympanic membrane perforations,which helps minimize the surgical trauma and reduces operation time and postoperative pain.

慢性化脓性中耳炎患者耳鸣发生现况、高危因素及预测模型构建与评价

目的分析慢性化脓性中耳炎患者耳鸣发生现况,调查高危因素并构建预测模型。方法选取2020年10月至2022年10月南阳市中心医院耳鼻咽喉头颈外科就诊的103例慢性化脓性中耳炎患者,回顾性收集患者的临床资料,分析慢性化脓性中耳炎患者耳鸣发生现况。通过单因素及多因素分析慢性化脓性中耳炎患者耳鸣发生的高危因素,建立预测模型,并绘制受试者工作特征(ROC)曲线分析预测模型对慢性化脓性中耳炎患者耳鸣发生的预测价值。结果103例慢性化脓性中耳炎患者耳鸣发生45例(43.69%)纳入耳鸣组,非耳鸣组58例。多因素logistic分析结果显示,咽鼓管鼓口异常、睡眠障碍、血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平升高为慢性化脓性中耳炎患者耳鸣发生的高危因素(P<0.05)。将上述因素纳入预测模型,将耳鸣患者纳入阳性,非耳鸣患者纳入阴性,按照预测模型绘制ROC曲线,结果显示,当logit(P)>14.60时,曲线下面积(AUC)为0.906,灵敏度为86.67%、特异度为87.93%。结论慢性化脓性中耳炎患者耳鸣发生率较高,咽鼓管鼓口异常、睡眠障碍、血清IL-6、IL-8、TNF-α水平升高与疾病发生密切相关,据此建立的预测模型预测价值较高,可为临床防治策略制定提供依据。

耳内镜下保留及重建上鼓室功能中耳手术治疗慢性中耳炎的效果

目的探讨耳内镜下保留及重建上鼓室功能中耳手术的经验和疗效。方法2021年8月—2022年5月我科收治的慢性化脓性中耳炎患者106例(113耳),依据炎症程度及听力情况分为A、B、C 3组,分别在耳内镜下行不同范围开放上鼓室+保留/重建听骨链手术。术后随访6个月以上,观察鼓膜修补成功率、炎症复发率、干耳时间,比较手术前后的平均听阈低频(0.125、0.25 kHz)气导(AC)、语频AC及气骨导差(ABG)。结果所有患耳2个月内获得干耳,无复发感染或再次鼓膜穿孔。A组、B组所有患耳术后ABG<20 dB。C组除1耳听骨链移位未重建,术后听力无改善,其余病例听力都有明显提高。结论耳内镜下施行上鼓室径路保留乳突的鼓室成形术,酌情进行有效的个体化选择,手术更加微创,术后复发率低,听力提高效果好。

不同乳突根治术联合鼓室成形术治疗慢性化脓性中耳炎的临床效果对比

目的探讨不同乳突根治术联合鼓室成形术治疗慢性化脓性中耳炎的临床效果。方法86例慢性化脓性中耳炎患者根据手术方法的不同分为两组。完壁组采用完壁式乳突根治术联合鼓室成形术治疗,开放组采用开放式乳突改良根治术联合鼓室成形术治疗。比较两组的术后恢复情况、复发率及听力阈值。结果术后,两组的鼓膜愈合情况比较,差异无统计学意义(P>0.05);完壁组的干耳时间短于开放组,复发率高于开放组(P<0.05)。术后6个月,两组的500、1000、2000 Hz听力阈值比较,差异无统计学意义(P>0.05);完壁组的4000 Hz听力阈值低于开放组(P<0.05)。结论与开放式乳突改良根治术联合鼓室成形术相比,完壁式乳突根治术联合鼓室成形术对慢性化脓性中耳炎患者高频听力的重建效果更佳,术后干耳更快,但复发率较高。

全耳内镜下耳屏软骨-软骨膜复合体在上鼓室外侧壁重建中的临床应用

目的探究全耳内镜下耳屏软骨-软骨膜复合体在上鼓室外侧壁重建中的临床应用。方法选取2020年6月~2023年6月间徐州市中心医院收治的58例进行上鼓室外侧壁重建的胆脂瘤患者,根据采用修复材料的不同分为对照组及观察组各29例。对照组采用耳屏软骨膜进行上鼓室外侧壁重建,观察组采用耳屏软骨-软骨膜复合体进行上鼓室外侧壁重建,两组患者均于全耳内镜下进行手术。统计患者术中出血量、手术时间,术后3个月复查听力情况、干耳情况及耳道功能改善情况,术后随访6个月鼓膜愈合情况。结果与术前比较,术后3个月气导听阈、气骨导差降低(P<0.05),与对照组比较,观察组气导听阈、气骨导差降低(P<0.05);与对照组比较,观察组干耳率、耳道功能良好率、听力提高成功率均升高,干耳时间缩短,但耳屏愈合时间增加(P<0.05);与对照组比较,观察组手术时间缩短,术中出血量减少(P<0.05);观察组、对照组术后并发症总发生率分别为13.79%、24.14%,二者比较差异无统计学意义(P>0.05);观察组愈合良好率高于对照组(86.21%vs.62.07%)(P<0.05),两组患者耳膜穿孔(10.34%vs.24.14%)、鼓膜移位(3.45%vs.6.90%)及鼓膜回缩(0.00%vs.6.90%)发生情况比较,差异无统计学意义(P>0.05)。结论全耳内镜下耳屏软骨-软骨膜复合体在上鼓室外侧壁重建中有利于改善患者听力,有利于术后恢复。

慢性化脓性中耳炎患者行鼓室成形术中植入钛人工听骨链在降低听力阈值及改善听力状态中的价值

目的探讨鼓室成形术中植入钛人工听骨链降低慢性化脓性中耳炎患者听力阈值、改善听力状态的效果。方法选取河南科技大学第二附属医院耳鼻咽喉科2019年1月至2022年1月80例慢性化脓性中耳炎患者作为研究对象,随机数字表法分为对照组(40例)和植入组(40例)。对照组采取单纯鼓室成形术,进行自体听骨链重建,未植入钛人工听骨链,植入组患者在行鼓室成形术中植入钛人工听骨链,对比两组术前术后纯音听力重建水平,听力状态改善效果及并发症、复发率。结果植入组听力改善有效率高于对照组(P<0.05);术后听力阈值均较术前降低,且植入组气导听力阈值、气骨导差低于对照组(P<0.05),骨导听力阈值组间差异无统计学意义(P>0.05);两组术后并发症发生率、复发率差异无统计学意义(P>0.05)。结论在行鼓室成形术中植入钛人工听骨链能有效提升慢性化脓性中耳炎患者的听力水平,降低气导听力阈值及气骨导差,且不增加术后并发症及疾病复发风险,效果确切,值得临床应用及进一步研究。