耳屏软骨-软骨膜复合体厚度测量及其在鼓室成形术中的应用  

The Measurements of the Thickness and Application of Tragus Cartilage-Perichondrium Complex in Tympanoplasty

作　　者：杜娟[1] 许为青[1] 赵海专[2] 

机构地区：[1]安徽医科大学附属安徽省立医院耳鼻咽喉头颈外科,合肥230001 [2]武汉大学人民医院医疗部

出　　处：《听力学及言语疾病杂志》2014年第3期257-260,共4页Journal of Audiology and Speech Pathology

基　　金：2013年安徽省卫生厅医学科研课题计划(13zc042)资助

摘　　要：目的测量耳屏软骨-软骨膜复合体厚度，探讨其对中耳炎手术治疗效果及重建听力的影响。方法49例（50耳）慢性中耳炎患者根据病情行伴或不伴乳突根治的鼓室成形术，均以耳屏软骨-软骨膜复合体修补鼓膜，术中测量耳屏软骨-软骨膜复合体厚度，术后每周随访一次至干耳，术后半年复查纯音听阈，分析耳屏软骨-软骨膜复合体厚度、干耳与否、干耳时间、鼓膜生长情况、术前和术后半年0．5、1．0、2．0、3．0kHz频率的纯音听阈。结果50耳耳屏软骨-软骨膜复合体的平均厚度为0．87±0．08mm（0．72～1．07mm），干耳时间3～12w，中位数3w；42耳术后随访半年，鼓膜形态、色泽良好；其中31耳患耳气骨导差缩小，听力提高，另11耳听力结果未纳入分析。结论耳屏软骨-软骨膜复合体的厚度较恒定，作为修复中耳材料具有干耳时间较短、利于听力改善、并发症较少等特点。Objective By measuring the thickness of tragus cartilage--perichondrium complex in 50 ears, to evaluate the feasibility and efficacy of practical application with tragus cartilage-periehondrium complex in the tympanoplasty based on a clinical trial. Methods A retrospective study was carried out among 50 ears with chronic otitis media,treated in our hospital by a surgical procedure with tragus cartilag--perichondrium complex used in the tympanoplasty. The thickness of tragus cartilage--perichondrium complex was mearured during operation. Postoperative following-up was completed once a week to ear--drying. The pure tone audiometry（PTA） was reexamined at half a year after operation. The observations included the thickness of tragus cartilage--perichondrium comple, the dry status, drying time of tympanic membrane, and the preoperative and half a year postoperative PTA. Results The average thickness of tragus eartilage--perichondrium complex in the 50 ears was 0.87±0.08 mm（0. 72-1.07 mm）. The cartilage perichondrium composite graft was applied in the tyrnpanoplasty while the median of drying ear time was 3 weeks in 50 ears. The average air--bone gaps of pure tone audiometry（PTA- AJ3G） of 0. 5,1.0,2.0,3.0 kHz decreased at half a year after the operatioru The colors and forms of the tympanic membrane were satisfactory except the attic lateral wall and the posterior wall of the external auditory canal had collapsed in one ear. Conclusion The thickness of tragus cartilageperichondrium complex is stable,can be used in the tympanoplasty with obvious benefits.

关 键 词：耳屏软骨-软骨膜复合体 鼓室成形术 纯音听阈 

分 类 号：R764.922[医药卫生—耳鼻咽喉科]