耳内镜下耳屏软骨膜双瓣鼓膜修补术治疗鼓膜大穿孔的效果  

Effect of double flap tympanic membrane repair with tragus and peri⁃chondrium under otoscope on large tympanic membrane perforation

作　　者：缪世军 石建华[1] 黄莉丽 Miao Shijun;Shi Jianhua;Huang Lii(Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou 215028,China)

机构地区：[1]上海交通大学医学院苏州九龙医院,江苏苏州215028

出　　处：《海军医学杂志》2024年第1期86-90,共5页Journal of Navy Medicine

摘　　要：目的 观察耳内镜下耳屏软骨膜双瓣鼓膜修补术治疗鼓膜大穿孔的效果。方法 选取上海交通大学医学院苏州九龙医院2018年1月至2022年8月收治的80例鼓膜大穿孔患者为研究对象,采用随机数字表法分为显微镜组和耳内镜组,每组各40例。显微镜组和耳内镜组分别给予显微镜下和耳内镜下耳屏软骨膜双瓣鼓膜修补术治疗,比较2组患者治疗效果。结果 耳内镜组手术时间[(49.02±7.77) min]、住院时间[(4.89±1.02) d]短于显微镜组[(78.96±9.85) min、(6.22±1.41) d],术中出血量[(7.21±2.25) ml]少于显微镜组[(14.55±5.23) ml],并发症发生率与显微镜组比较,差异无统计学意义(P>0.05)。与术前比较,2组患者术后3个月气导听阈、骨导听阈及气骨导差均下降(P<0.05)。与术前比较,2组患者术后3个月耳鸣分级均降低(P<0.05)。与术前比较,2组患者术后3个月物质生活、社会关系、躯体功能、心理功能评分均升高,且耳内镜组高于显微镜组(P<0.05)。2组患者术后1个月、3个月鼓膜愈合率比较,差异无统计学意义(P>0.05)。结论 耳内镜下鼓膜修补术手术时间短,出血少,术后恢复快,可改善听力,减轻耳鸣症状,提高患者生活质量。Objective To observe the clinical outcomes of double flap tympanic membrane repair with tragus and peri‐chondrium under otoscope in the treatment of large tympanic membrane perforation.Methods Eighty patients with large tympanic membrane perforation admitted to Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine from January 2018 to August 2022 were enrolled and divided into 2 groups by random number table method.Double flap tympanic membrane repair with tragus and peri‐chondrium under microscope and otoscope were performed in microscope group and endoscopic group,respectively.The therapeutic effect was compared between the 2 groups.Results The operation time and hospital stay of the endoscopic group were shorter than those of the microscope group([49.02±7.77]min vs.[78.96±9.85]min,[4.89±1.02]d vs.[6.22±1.41]d),and intraoperative blood loss of the endoscopic group was less than that of the microscope group([7.21±2.25]ml vs.[14.55±5.23]ml).There was no significant difference in the incidence of complications between the 2 groups(P>0.05).Compared with preoperative ones,the auditory threshold of air conduction,auditory threshold of bone conduction,air bone gap and tinnitus grade were reduced in both groups 3 months after operation(P<0.05),while the scores of material life,social relationship,physical function and psychological function were increased,and the scores of the endoscopic group were significantly higher than those of the microscope group(P<0.05).There was no significant difference in the healing rate of eardrum 1 month or 3 months after operation between the 2 groups(P>0.05).Conclusion Otoscopic tympanic membrane repair has short operation time,less bleeding and quick postoperative recovery.It can improve hearing,alleviate tinnitus symptoms and improve patients’quality of life.

关 键 词：耳内镜 显微镜 鼓膜修补术 鼓膜大穿孔 生活质量 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]