耳内镜结合耳屏软骨-软骨膜在鼓室成形术中的应用研究  

Application research of otoscope combined with tragus cartilage-perichondrium in tympanoplasty

作　　者：罗伟国 蒙玉兰 张巧仪 王路 张焕玲 梁艳敏 LUO Weiguo;MENG Yulan;ZHANG Qiaoyi;WANG Lu;ZHANG Huanling;LIANG Yanmin(Department of ENT&HN Surgery,Zhaoqing Hongqiang Rehabilitation Hospital,Guangdong,Zhaoqing 526100,China;Department of ENT,Traditional Chinese Medicine Hospital of Gaoyao District in Zhaoqing City,Guangdong,Zhaoqing 526100,China;Department of ENT,Shenzhen University General Hospital,Guangdong,Shenzhen 518071,China)

机构地区：[1]广东省肇庆泓强康复医院耳鼻喉头颈外科,广东肇庆526100 [2]广东省肇庆市高要区中医院五官科,广东肇庆526100 [3]深圳大学总医院耳鼻咽喉科,广东深圳518071

出　　处：《中国医药科学》2022年第16期160-164,共5页China Medicine And Pharmacy

基　　金：广东省肇庆市科技创新指导类项目(201804031204)。

摘　　要：目的分析耳内镜结合耳屏软骨-软骨膜在鼓室成形术中的应用效果。方法选择2018年2月至2020年10月肇庆市高要区中医院耳鼻咽喉科收治的慢性中耳炎(COM)患者63例,随机分为观察组32例和对照组31例,对照组给予耳显微镜下颞肌筋膜行鼓室成形术治疗,观察组给予耳内镜下结合耳屏软骨-软骨膜鼓室成形术治疗,观察两组听力恢复情况,包括术前、术后气骨导差及听力增益和听力改善(术后听力增益>5 dB)百分比,手术时间;记录治疗6个月两组0.5、1.0、2.0、4.0 kHz频率下气骨导差;对比两组治疗6个月干耳时间、移植物成活率和术后并发症发生率。结果两组术前、术后气骨导差及听力增益、听力改善百分比比较,差异无统计学意义(P>0.05)。观察组手术时间明显少于对照组,差异有统计学意义(P<0.05)。治疗6个月随访,两组治疗后0.5、1.0、2.0、4.0 kHz的气骨导差明显低于治疗前,差异有统计学意义(P<0.05),观察组治疗后0.5、1.0、2.0、4.0 kHz的气骨导差与对照组比较,差异无统计学意义(P>0.05)。治疗6个月,观察组干耳时间明显短于对照组,移植物成活率明显高于对照组,差异有统计学意义(P<0.05),两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论耳内镜下结合耳屏软骨在鼓室成形术治疗COM患者,术后并发症发生率及听力恢复方面情况与耳显微镜下颞肌筋膜行鼓室成形术相当,但手术时间与干耳时间更具优势,移植物成活率高,可有效缩短手术时间、清理病变、减轻手术副损伤,值得临床大力推广应用。Objective To analyze the application efficacy of otoscope combined with tragus cartilageperichondrium in tympanoplasty.Methods A total of 63 cases of patients with chronic otitis media(COM)admitted to and treated in the Department of ENT in the Traditional Chinese Medicine Hospital of Gaoyao District in Zhaoqing City from February 2018 to October 2020 were selected,and they were randomly divided into the observation group(n=32)and the control group(n=31).The control group was treated with tympanoplasty of temporalis fascia under otoscope,while the observation group was treated with otoscope combined with tragus cartilage in tympanoplasty.And the hearing recovery of the two groups was observed,including preoperative and postoperative air-bone conduction difference,hearing gain and the percentage of hearing improvement(postoperative hearing gain>5 dB),and operation time.After 6 months of treatment,the differences in air-bone conduction between the two groups at 0.5,1.0,2.0 and 4.0 kHz frequency were recorded.The dry ear time,graft survival rate and incidence of postoperative complications were compared between the two groups after 6 months of treatment.Results There were no statistically significant differences between the two groups in preoperative and postoperative air-bone conduction difference, postoperative hearing gain and hearing improvement percentage differences (P > 0.05). The operation time of the observation group was significantly shorter than that of the control group, with statistically significant difference (P < 0.05). After 6 months of treatment of follow-up, the air-bone conduction differences between the two groups at 0.5, 1.0, 2.0 and 4.0 kHz after treatment were significantly lower than those before treatment, with statistically significant differences (P < 0.05). After treatment, there was no statistically significant difference in the air-bone conduction differences between the observation group and the control group at 0.5, 1.0, 2.0 and 4.0 kHz (P > 0.05). After 6 months of treatment, the d

关 键 词：慢性中耳炎 耳内镜 耳屏软骨-软骨膜复合体 鼓室成形术 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]