耳内镜下超薄耳屏软骨-软骨膜修补鼓膜大穿孔的应用研究  

Clinical investigation of endoscopic ultrathin tragus cartilage-perichondrium myringoplasty for treatment of large tympanic membrane perforations

作　　者：李鹏 钟玉红 李晓雪 钟庆雯 蔡开贵[1] 汤素琴[1] 苏娟[2] LI Peng;ZHONG Yuhong;LI Xiaoxue;ZHONG Qingwen;CAI Kaigui;TANG Suqing;SU Juan(Department of Otorhinolaryngology,Huadu District People’s Hospital of Guangzhou,Guangzhou 510800,China;Department of Otorhinolaryngology Head and Neck Surgery,Guangzhou First People’s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市花都区人民医院耳鼻咽喉科,广东广州510800 [2]广州市第一人民医院耳鼻咽喉头颈外科,广东广州510180

出　　处：《广州医药》2024年第3期284-288,共5页Guangzhou Medical Journal

基　　金：广州花都区科技计划项目(21-HDWS-041)。

摘　　要：目的探讨耳内镜下超薄耳屏软骨-软骨膜修补鼓膜大穿孔的效果。方法回顾性分析31例应用超薄耳屏软骨-软骨膜行耳内镜下夹层法鼓膜修补术的患者资料,随访6个月,分析术后鼓膜愈合率、听力恢复情况。结果30例鼓膜愈合,成功率96.8%,无移植物外移、内陷、钝角愈合;术前平均气导听阈为(38.3±3.3)dB HL,骨气导差为(23.5±3.1)dB HL,术后平均气导听阈为(22.3±1.6)dB HL,骨气导差为(6.3±2.5)dB HL,听力较术前提高(P<0.001)。结论超薄耳屏软骨-软骨膜在耳内镜下鼓膜大穿孔修补术中效果较好,并发症少,是可靠的修复材料,值得临床推广应用。Objective To investigate the clinical efficacy of endoscopic ultrathin tragus cartilage-perichondrium as graft material for treatment of large tympanic membrane perforations.Methods A total of 31 cases(31 ears)which were diagnosed as chronic suppurative otitis with large tympanic membrane perforation were performed endoscopic myringoplasty with ultrathin tragus cartilage-perichondrium by sandwich technique.The pure tone threshold average(PTA)of speech frequency and the air-bone gap were assessed at 6 month safter surgery.Results Successful closure without reperforation was obtained in 30 of 31 patients(96.8%).There was no graft lateralization,anterior blunting.Average postoperative air conduction and bone-air conduction gap were(22.3±1.6)dB HL and(6.3±2.5)dBHL compared with(38.3±3.3)dB HL and(23.5±3.1)dB HL preoperatively(P<0.001).Conclusions The ultrathin tragus cartilage-perichondrium is liable repair material for large tympanic membrane perforation with excellent graft take and significant improvement of hearing,which is worthy of clinical promotion.

关 键 词：鼓膜穿孔 鼓膜成形术 内镜 软骨-软骨膜 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]