带软骨膜软骨在鼓室成形术中的应用  

Cartilage perichondrium composite graft in tympanoplasty

作　　者：何强[1] 张颖[1] 贾占伟[1] 张玉波[1] HE Qiang;ZHANG Ying;JIA Zhan-wei;ZHANG Yu-bo(Department of Otolaryngology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院耳鼻喉科,河北石家庄050000

出　　处：《河北医科大学学报》2019年第5期543-546,共4页Journal of Hebei Medical University

摘　　要：目的观察带软骨膜软骨应用于鼓室成形术中治疗单侧慢性化脓性中耳炎传导性听力损失患者的干耳时间及听力恢复情况。方法选择单侧慢性化脓性中耳炎传导性听力损失患者121例,根据情况行开放式或完壁式鼓室成形术,并行一期或二期听骨链重建。术中应用带软骨膜软骨作为鼓室支撑材料,颞肌筋膜修补。结果 121例患者中行一期听骨链重建71例,二期听骨链重建11例,未行听骨链重建只采用清除病变者39例。术后12个月,一期重建听骨链和二期重建骨链者平均骨气导差(air bone gap,ABG)均明显低于术前,差异有统计学意义(P<0.05);未行听力重建仅清除病变者ABG与术前比较差异无统计学意义(P>0.05)。结论带软骨膜软骨作为中耳支撑材料用于鼓室成形术可以维持鼓室容积,利于咽鼓管功能恢复,缩短干耳时间,有助于听力恢复。Objective To analyze the duration of dry ear and hearing recovery of patients with unilateral chronic suppurative otitis media with conductive hearing loss treated with perichondrium cartilage during tympanoplasty.Methods One hundred and twenty-one cases of patients were recruited with unilateral chronic suppurative otitis media who were performed with open or complete wall tympanoplasty and the auditory ossicular chain was reconstructed in stageⅠorⅡ.The perichondrium cartilage was used as the supporting material of tympanum and the temporalis muscle fascia was repaired in the operation.Results Seventy-one cases of patients were preformed with reconstruction of ossicular chain at stageⅠ,and 11 patients were preformed with reconstruction of ossicular chain at stageⅡ.The rest of patients were underwent the removal of lesions without reconstruction of ossicular chain.After 12 months of surgery,the average air bone gap(ABG)of patients who were conducted with reconstruction of ossicular chain at stageⅠand stageⅡwere obviously lower than that of preoperation,with statistically significant difference(P<0.05).Compared with the ABG of preoperation,the ABG of patients who were underwent the removal of lesions without reconstruction of ossicular chain was no significantly difference(P>0.05).Conclusion As a middle ear supporting material,perichondrium cartilage can maintain the volume of tympanoplasty,facilitate the recovery of eustachian tube function,shorten the dry ear time,and contribute to hearing recovery.

关 键 词：中耳炎 鼓室成形术 软骨膜软骨 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]