耳内镜下耳屏软骨-软骨膜修补鼓膜大穿孔的临床观察

李鹏; 张奕; 符秋养; 孟庆翔; 谢景华; 梁勇

doi:10.13201/j.issn.1001-1781.2014.22.010

耳内镜下耳屏软骨-软骨膜修补鼓膜大穿孔的临床观察

- 1 南方医科大学附属南方医院耳鼻咽喉头颈外科(广州, 510515);
- 2 广州市第一人民医院耳鼻咽喉科

详细信息

通讯作者: 梁勇,E-mail:yliang@fimmu.com

中图分类号: R764

收稿日期: 2014-08-02

The effectiveness of endoscopic tragus cartilage-perichondrium myringoplasty in the treatment of large tympanic membrane perforations

- 1 Department of Otorhinolaryngology-Head and Neck Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, 510515, China;
- 2 Department of Otorhinolaryngology, Guangzhou First People's Hospital

More Information

Corresponding author: LIANG Yong, E-mail: yliang@fimmu.com

Received Date: 02 August 2014

摘要

摘要: 目的:探讨耳内镜下采用耳屏软骨-软骨膜修补鼓膜大穿孔的效果。方法:回顾性分析耳内镜下35例采用软骨-软骨膜进行鼓膜大穿孔修补的患者,随访至少1年,对术后鼓膜愈合率、听力恢复情况进行分析。结果:33例鼓膜愈合,成功率为94.3%,无移植物外移、内陷、钝角愈合、胆脂瘤形成、感音神经性聋;术前平均气导听阈为(43.8±5.7)dB HL,骨气导差为(28.5±3.1)dB HL,术后平均气导听阈为(31.4±6.4)dB HL,骨气导差为(16.2±4.1)dB HL,听力较术前明显提高(P<0.01), 其中27例骨气导差小于20 dB,占77%。结论:耳内镜下耳屏软骨-软骨膜修补鼓膜大穿孔可获得较高的愈合率和良好的听力效果,值得临床推广。
- 鼓膜穿孔 /
- 鼓膜成形术 /
- 内镜 /
- 软骨-软骨膜
Abstract: Objective:To evaluate effectiveness of endoscopic tragus cartilage-perichondrium in the treatment of large tympanic membrane perforations. Method:Patients with large tympanic membrane perfortations who had underwent cartilage-perichondrium myringoplasty were retrospectively retrieved from our department. Those with a follow-up of equal to or greater than 12 months after surgery were included in the study. Hearing test results were reported using a four-frequency air conduction and bone-air conduction gap. Patients were labeled as treatment success if the tympanic membrane was intact without lateralization or anterior blunting after surgery. Result:Of the 35 patients with large tympanic membrane perforations treated by endoscopic tragus cartilage-perichondrium, 33 (94.3%) were treatment success. There was no graft lateralization, anterior blunting, neocholesteatoma, and sensorineural hearing loss in these patients after surgery. The air conduction and bone-air conduction gap before surgery in the study cohort were (43.8±5.7)dB and (28.5±3.1) dB, respectively. Postoperative air conduction and bone-air conduction gap of the cohort were (31.4±6.4) dB HL and (16.2±4.1)dB, respectively. The postoperative air conduction and bone-air conduction gap decreased significantly after surgery (P<0.01). Overall postoperative air-bone gap in 27 of the 35 patients (77%) were less than 20 dB after surgery. Conclusion:Endoscopic cartilage-perichondrium myringoplasty is an effective procedure in the treatment of large tympanic membrane perforations.
- tympanic membrane perforation /
- myringoplasty /
- endoscopy /
- cartilage-perichondrium

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参考文献(6)

[1]	胡明, 周正娟, 潘中柱, 等.耳内镜下鼓膜成形术32例临床分析[J].临床耳鼻咽喉头颈外科杂志, 2011, 25 (10) :472-473.
[2]	KAKEHATA S, FUTAI K, SASAKI A, et al.Endoscopic transtympanic tympanoplasty in the treatment of conductive hearing loss:early results[J].Otol Neurotol, 2006, 27:14-19.
[3]	胡美丽, 应根东, 龙益兴, 等.应用耳内镜治疗上鼓室内陷袋的临床研究[J].临床耳鼻咽喉头颈外科杂志, 2008, 22 (22) :1043-1045.
[4]	LADE H, CHOUDHARY S R, VASHISHTH A.Endoscopic vs microscopic myringoplasty:a different perspective[J].Eur Arch Otorhinolaryngol, 2014, 271:1897-1902.
[5]	GERBER M J, MASON J C, LAMBERT R R.Hearing results after primary cartilage tympanoplasty[J].Laryngoscope, 2000, 110:1994-1999.
[6]	AYACHE S.Cartilaginous myringoplasty:the endoscopic transcanal procedure[J].Eur Arch Otorhinolaryngol, 2013, 270:853-860.