耳内镜下不同类型耳屏软骨-软骨膜修补鼓膜穿孔临床疗效分析

王伟; 强化龙; 程忠强; 李中燕; 袁润生

doi:10.13898/j.cnki.issn.1000-2200.2022.09.002

耳内镜下不同类型耳屏软骨-软骨膜修补鼓膜穿孔临床疗效分析

Clinical effect analysis of repairing tympanic membrane perforation with different types of tragus cartilage-perichondrium under otoendoscope

摘要

摘要:
目的探讨耳内镜下不同类型的耳屏软骨-软骨膜修补鼓膜穿孔的临床疗效。
方法选取60例(60耳)实施耳内镜手术的病人，随机分为对照组和观察组各30例，其中对照组采用全厚岛状耳屏软骨-软骨膜修补鼓膜穿孔；观察组采用半厚岛状耳屏软骨-软骨膜复合体修补鼓膜穿孔。所有病人随访6~12个月，对比分析2组鼓膜穿孔的鼓膜愈合情况及听力改善情况。
结果观察组鼓膜愈合率100.0%(30/30)，高于对照组80.0%(24/30)(P < 0.05)。2组术前气导听阈、气骨导差值差异均无统计学意义(P>0.05)，术后观察组气导听阈、气骨导差值均明显优于对照组(P < 0.01), 且组内比较结果显示，术后2组气导听阈、气骨导差值均明显优于术前(P < 0.01)。
结论耳内镜下耳屏软骨-软骨膜修补穿孔的鼓膜是可行的，尤其半厚岛状耳屏软骨-软骨膜复合体成活率高，可修补不同大小的鼓膜穿孔，且益于提高听力，术后听力改善效果良好。

Abstract:
ObjectiveTo investigate the clinical efficacy of repairing tympanic membrane perforation with different types of tragus cartilage-perichondrium under otoendoscope.
MethodsSixty patients (60 ears) who underwent endoscopic surgery were randomly divided into the control group (n=30) and the observation group (n=30).In the observation group, the perforation of tympanic membrane was repaired by semi-thick island of tragus cartilage-perichondrium complex.All patients were followed up for 6-12 months.The healing of tympanic membrane and hearing improvement were compared between the two groups.
ResultsThe healing rate of tympanic membrane in the observation group was 100.0% (30/30), which was higher than 80.0%(24/30) in the control group (P < 0.05).There was no significant difference in the air-conductance threshold and air-bone conductance difference between the two groups before operation (P>0.05).The air-conductance threshold and air-bone conductance difference of the observation group were significantly better than those of the control group (P < 0.01), and the intra-group comparison showed that the air-conductance threshold and air-bone conductance difference of the two groups after operation were significantly better than those before operation (P < 0.01).
ConclusionsIt is feasible to repair the perforated tympanic membrane under otoendoscope, especially the semi-thick island of auricular cartilage-perichondrium complex, which has a high survival rate, can repair the perforation of tympanic membrane of different sizes, and is beneficial to improve hearing, and the postoperative hearing improvement effect is good.

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