广州医药 ›› 2024, Vol. 55 ›› Issue (3): 284-288.DOI: 10.3969/j.issn.1000-8535.2024.03.011

• 论著 • 上一篇    下一篇

耳内镜下超薄耳屏软骨-软骨膜修补鼓膜大穿孔的应用研究

李鹏1, 钟玉红1, 李晓雪1, 钟庆雯1, 蔡开贵1, 汤素琴1, 苏娟2   

  1. 1 广州市花都区人民医院耳鼻咽喉科(广东广州 510800);
    2 广州市第一人民医院耳鼻咽喉头颈外科(广东广州 510180)
  • 收稿日期:2023-11-12 出版日期:2024-03-20 发布日期:2024-04-12
  • 通讯作者: 苏娟,E-mail:651411611@qq.com
  • 基金资助:
    广州花都区科技计划项目(21-HDWS-041)

Clinical investigation of endoscopic ultrathin tragus cartilage-perichondrium myringoplasty for treatment of large tympanic membrane perforations

LI Peng1, ZHONG Yuhong1, LI Xiaoxue1, ZHONG Qingwen1, CAI Kaigui1, TANG Suqing1, SU Juan2   

  1. 1 Department of Otorhinolaryngology,Huadu District People's Hospital of Guangzhou,Guangzhou 510800,China;
    2 Department of Otorhinolaryngology Head and Neck Surgery,Guangzhou First People's Hospital,Guangzhou 510180,China
  • Received:2023-11-12 Online:2024-03-20 Published:2024-04-12

摘要: 目的 探讨耳内镜下超薄耳屏软骨-软骨膜修补鼓膜大穿孔的效果。方法 回顾性分析31例应用超薄耳屏软骨-软骨膜行耳内镜下夹层法鼓膜修补术的患者资料,随访6个月,分析术后鼓膜愈合率、听力恢复情况。结果 30例鼓膜愈合,成功率96.8%,无移植物外移、内陷、钝角愈合;术前平均气导听阈为(38.3±3.3)dB HL,骨气导差为(23.5±3.1)dB HL,术后平均气导听阈为(22.3±1.6)dB HL,骨气导差为(6.3±2.5)dB HL,听力较术前提高(P<0.001)。结论 超薄耳屏软骨-软骨膜在耳内镜下鼓膜大穿孔修补术中效果较好,并发症少,是可靠的修复材料,值得临床推广应用。

关键词: 鼓膜穿孔, 鼓膜成形术, 内镜, 软骨-软骨膜

Abstract: Objective To investigate the clinical efficacy of endoscopic ultrathin tragus cartilage-perichondrium as graft material for treatment of large tympanic membrane perforations. Methods A total of 31 cases(31 ears)which were diagnosed as chronic suppurative otitis with large tympanic membrane perforation were performed endoscopic myringoplasty with ultrathin tragus cartilage-perichondrium by sandwich technique.The pure tone threshold average(PTA)of speech frequency and the air-bone gap were assessed at 6 month safter surgery. Results Successful closure without reperforation was obtained in 30 of 31 patients(96.8%).There was no graft lateralization,anterior blunting .Average postoperative air conduction and bone-air conduction gap were(22.3±1.6)dB HL and(6.3±2.5)dBHL compared with(38.3±3.3)dB HL and(23.5±3.1)dB HL preoperatively(P<0.001). Conclusions The ultrathin tragus cartilage-perichondrium is liable repair material for large tympanic membrane perforation with excellent graft take and significant improvement of hearing,which is worthy of clinical promotion.

Key words: tympanic membrane perforation, myringoplasty, endoscopy, cartilage-perichondrium