耳内镜与显微镜下I型鼓室成形术的临床疗效分析  

Clinical effect analysis of type I tympanoplasty with otoscope and microscope

作　　者：毛承刚[1] 周小淳[1] 万俐佳[1] 鲁海涛[1] 姜义道[1] 陶泽璋[2] Mao Chenggang;Zhou Xiaochun;Wan Lijia;Lu Haitao;Jiang Yidao;Tao Zezhang(Department of Otolaryngology,Jingzhou Central Hospital,the Second Clinical Medical College,Yangtze University,Jingzhou 434020,China;Department of Otolaryngology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]荆州市中心医院,长江大学第二临床医学院耳鼻咽喉科,434020 [2]武汉大学人民医院耳鼻咽喉科,430060

出　　处：《国际耳鼻咽喉头颈外科杂志》2020年第6期314-317,共4页International Journal of Otolaryngology-Head and Neck Surgery

基　　金：荆州市科技局基金资助项目(2019HC31)。

摘　　要：目的通过比较耳内镜与显微镜下Ⅰ型鼓室成形术的临床疗效,探讨耳内镜下Ⅰ型鼓室成形术的可行性。方法研究对象为2016年1月至2019年9月于荆州市中心医院耳鼻咽喉科接受Ⅰ型鼓室成形术的96例患者,按手术方式分为2组,一组耳内镜下Ⅰ型鼓室成形术(耳内镜组),共52例(52耳),另一组显微镜下Ⅰ型鼓室成形术(显微镜组),共44例(44耳)。比较两组的手术时间、术中出血量、鼓膜修补成功率、术耳术前与术后的气骨导差。结果耳内镜组手术时间(50.5±11.2)min比显微镜组手术时间(88.3±12.1)min短(P<0.05)。术后随访3个月,耳内镜组鼓膜修补成功率为92.3%,显微镜组为93.2%,两组比较差异无统计学意义(P>0.05)。术后随访3个月,耳内镜组术前气骨导差为(18.8±6.9)dB,术后为(10.2±1.7)dB(P<0.05)。显微镜组术前气骨导差为(17.9±7.2)dB,术后为(11.6±1.2)dB(P<0.05)。两组术后气骨导差较术前均有明显缩小,但术后气骨导差的差异在两组间无统计学意义(P>0.05)。结论耳内镜组与显微镜组相比,耳内镜下Ⅰ型鼓室成形术更具有微创、手术时间短、平均出血量少等优势,值得临床推广。Objective To compare the clinical efficacy of tympanoplasty with otoscope and microscopy to explore the feasibility of tympanoplasty with otoscope.Methods The research subjects were 96 patients who underwent type I tympanoplasty in our department from January 2016 to September 2019,and were divided into 2 groups according to the surgical method.Group one,a total of 52 cases(52 ears),another group of microscopic type I tympanoplasty(microscope group),a total of 44 cases(44 ears).The average operation time,average intraoperative blood loss,success rate of tympanic membrane repair,and air conduction difference before and after ear surgery were compared between the two groups.Results The average operation time of the otoscope group[(50.5±l 1.2)min]was shorter than the average operation time of the microscope group[(88.3±12.1)min](P<0.05).After 3 months of follow-up,the success rate of tympanic membrane repair in the otoscope group was 92.3%and that in the microscope group was 93.2%.There was no significant difference between the two groups(P>0.05).After 3 months of follow-up,the air-bone conduction difference in the otoscope group was(18.8±6.9)dB before operation and(10.2±1.7)dB after operation(P<0.05).In the microscope group,the air-bone conductance was(17.9±7.2)dB before operation and(11.6±1.2)dB after operation(P<0.05).The postoperative air-bone conduction difference between the two groups was significantly reduced compared with that before the operation.but the postoperative air-bone conduction difference was not statistically significant between the two groups(P>0.05).Conclusion Compared with the microscope group,otoscope endoscopy type I tympanoplasty has the advantages of minimally invasive,short operation time and low average bleeding,which is worthy of clinical promotion.

关 键 词：内窥镜检查 显微镜检查 鼓室成形术 耳内镜手术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]