耳内镜下内衬法与夹层法鼓膜修补术的疗效观察  

Curative effect of otoscopic underlay and interlay myringoplasty

作　　者：潘晓丹[1] 赵守琴[1] 赵燕玲[1] 李轶[1] PAN Xiaodan;ZHAO Shouqin;ZHAO Yanling;LI Yi(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第1期69-74,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的对耳内镜下内衬法和夹层法完成慢性化脓性中耳炎(CSOM)患者鼓膜修补术进行疗效观察。方法回顾性分析2019年6月—2021年6月收治的经耳内镜内衬法和夹层法行鼓膜修补的CSOM患者的临床资料,共66例CSOM患者入组观察,随机分为两组由同一术者分别以内衬法(33例)和夹层法(33例)完成I型鼓室成形术。比较其鼓膜愈合情况及术后听力改善情况。结果在内衬组(33例)鼓膜穿孔的患者中,31例愈合,愈合率为93.9%;夹层组(33例)鼓膜穿孔的患者中,32例愈合,愈合率97.0%。内衬组术前气骨导差(ABG)(21.76±9.43)dBHL,术后ABG(15.97±8.60)dBHL,平均提高6 dBHL,两组比较差异具有统计学意义(P=0.011)。夹层组术前ABG(19.06±8.40)dBHL,术后ABG(12.30±7.23)dBHL,平均提高7 dBHL,两组比较差异具有统计学意义(P=0.001)。结论经耳内镜下以内衬法和夹层法行鼓膜修补术,都能达到较理想的鼓膜愈合状态及听力改善情况。耳内镜手术耗时少、术后住院日短,在耳外科领域中有极大的发展空间。Objective To observe the curative effect of otoscopic underlay and interlay myringoplasty for chronic suppurative otitis media(CSOM).Methods Clinical data of 66 CSOM patients undergoing otoscopic myringoplasty with either underlay method or interlay method between June 2019 and June 2021 were retrospectively analyzed.Otoscopic type I myringoplasty with either underlay method or interlay method was performed by the same surgeon(33 cases in each group).The repair feature of tympanic membrane and hearing improvement between the two groups were compared.Results Satisfactory healing of perforation was achieved in 31 patients of the underlay group with a healing rate of 93.9%,and 32 of the interlay group with a healing rate of 97.0%.The preoperative and postoperative air-bone gaps(ABGs)in the underlay group were(21.76±9.43)dBHL and(15.97±8.60)dBHL with an increase of 6 dBHL on average(P=0.011),while those in the interlay group were(19.06±8.40)dBHL,(12.30±7.23)dBHL,and 7 dBHL respectively(P=0.001).Conclusions Otoscopic type I myringoplasty with either underlay method or interlay method can achieve an ideal tympanic membrane healing and hearing improvement indistinguishably.In addition,with less operation time and short postoperative hospital stay,otoscopic surgery has vast space for development.

关 键 词：耳内镜 鼓膜修补 内衬法 夹层法 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]