耳内镜下耳屏软骨膜鼓膜修补术20例临床分析  

Clinical analysis of otoendoscopic myringoplasty with tragus perichondrium in 20 cases

作　　者：李慧娟[1] Li Huijuan(Department of Otolaryngology,Suixian Traditional Chinese Medicine Hospital,Shangqiu 476900,Henan Province,China)

机构地区：[1]睢县中医院耳鼻咽喉科,商丘476900

出　　处：《中国基层医药》2023年第8期1225-1227,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析耳内镜下耳屏软骨膜鼓膜修补术的临床应用效果。方法回顾分析睢县中医院2019年3月至2020年3月收治的鼓膜穿孔患者20例的临床资料,其中6例外伤性鼓膜穿孔,14例慢性化脓性中耳炎(静止期)遗留的鼓膜穿孔;均采用耳内镜下耳屏软骨膜鼓膜修补术,术后观察鼓膜穿孔愈合及听力改善情况。结果术后随访复查12个月,6例外伤性鼓膜穿孔全部愈合,12例慢性化脓性中耳炎(静止期)遗留鼓膜穿孔患者鼓膜移植物均成活,1例术后愈合不良,余小穿孔,于二次局部麻醉下处理后愈合;1例因中耳感染穿孔未能愈合;愈合率95%。术前气导纯音听阈值(42±11)dBHL,术后12个月气导纯音听阈值(25±10)dBHL,两者差异有统计学意义(t=4.00,P<0.05)。20例鼓膜穿孔患者均无耳屏软骨感染、外耳道皮瓣坏死、周围性面瘫、听力下降、耳鸣等并发症的发生。结论耳内镜下耳屏软骨膜鼓膜修补术治疗鼓膜穿孔愈合率高,听力改善明显,无严重并发症,创伤小,恢复快。Objective To analyze the clinical application effect of otoendoscopic myringoplasty with tragus perichondrium.Methods The clinical data of 20 patients with tympanic membrane perforation who received treatment in Suixian Traditional Chinese Medicine Hospital from March 2019 to March 2020 were retrospectively analyzed.Among the 20 patients,6 patients had traumatic tympanic membrane perforation,and 14 patients had tympanic membrane perforation caused by chronic suppurative otitis media(stationary phase).All patients underwent otoendoscopic myringoplasty with tragus perichondrium.After surgery,the healing of tympanic membrane perforation and the improvement of hearing were evaluated.Results After surgery,all patients were followed up for 12 months.Traumatic tympanic membrane perforation healed in six patients.The tympanic membrane grafts survived in 12 patients with tympanic membrane perforation caused by chronic suppurative otitis media(stationary phase).One patient had poor postoperative healing and the remaining small perforation healed after secondary treatment under local anesthesia.Healing from tympanic membrane perforation was not achieved in one patient because of perforation caused by otitis media.The healing rate of tympanic membrane perforation caused by chronic suppurative otitis media was 95%.Before surgery,the air conduction pure tone hearing threshold was(42±11)dBHL,and it was(25±10)dBHL 12 months after surgery.There was a significant difference in air conduction pure tone hearing threshold between before and after surgery(t=4.00,P<0.05).No complications such as tragus cartilage infection,skin flap necrosis of external auditory meatus,peripheral facial paralysis,hearing loss,or tinnitus occurred in 20 patients with tympanic membrane perforation.Conclusion Otoendoscopic myringoplasty with tragus perichondrium leads to a high perforation healing rate,improves healing greatly,has no serious complications,produces minimal trauma,and contributes to a rapid recovery from tympanic membrane perforation.

关 键 词：鼓膜穿孔 鼓膜成形术 耳镜检查 耳软骨 听力检查 听阈 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]