耳内镜下耳屏软骨-双面软骨膜复合体在鼓膜大穿孔修复中的应用  

Ap plication of tragus cartilage-double-faced perichondrium complex in repair of large perforation of tympanic membrane under otoendoscope

作　　者：黄烨 戴信深 尤慧华 Huang Ye

机构地区：[1]浙江大学医学院附属金华医院,321000

出　　处：《浙江临床医学》2024年第7期964-966,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2021KY1177)。

摘　　要：目的 探讨耳内镜下采用耳屏软骨-双面软骨膜复合体修复鼓膜大穿孔中的应用价值。方法 纳入2021年1月至2023年1月鼓膜大穿孔患者79例(79耳),随机分为观察组(采用耳屏软骨-双面软骨膜复合体行鼓膜修复)40例和对照组(采用颞肌筋膜行鼓膜修复)39例,所有患者均采用内植法Ⅰ期完成手术,术后3个月复查纯音听阈及耳内镜,比较两组患者鼓膜愈合率、愈合形态及听力改善情况。结果术后3个月复查耳内镜,观察组鼓膜愈合率100%,对照组愈合率92.31%。观察组鼓膜形态比对照组更好。术后3个月复查听力学检查,观察组治疗前后气骨导差分别为(22.09±3.71)dB HL、(10.06±2.68)dB HL,差异有统计学意义(P<0.05);对照组治疗前后气骨导差分别为(21.79±5.83)dB HL、(10.58±3.37)dB HL,差异有统计学意义(P<0.05),两组患者治疗后气骨导差比较,差异无统计学意义(P>0.05)。结论 耳内镜下采用耳屏软骨-双面软骨膜复合体修复鼓膜大穿孔能降低术中取材难度、提高术后听力,是一种可靠的修复材料,值得在临床推广应用。Objective To explore the application value of the ear shield cartilage-bilateral cartilage membrane composite under ear endoscopy in repairing large perforations of the tympanic membrane.Methods 79 patients(79 ears)with large perforations of the tympanic membrane treated in the Department of Otolaryngology-Head and Neck Surgery,Jinhua Hospital Affiliated to Zhejiang University School of Medicine from January 2021 to January 2023 were included in this study.They were divided into a study group(40 cases treated with ear shield cartilage-bilateral cartilage membrane composite for tympanic membrane repair)and a control group(39 cases treated with temporal muscle fascia for tympanic membrane repair).All patients underwent one-stage surgery using the internal implantation method.Pure-tone audiometry and ear endoscopy were performed 3 months after surgery to analyze the tympanic membrane healing rate,healing morphology,and hearing improvement.Results Three months after surgery,ear endoscopy showed that the tympanic membrane healing rate in the study group(100%)was higher than that in the control group(92.31%).The morphology of the tympanic membrane in the study group was better than that in the control group.Three months after surgery,pure-tone audiometry showed that the air-bone gap difference before and after treatment in the study group was(22.09±3.71)dB HL and(10.06±2.68)dB HL,respectively,and the difference was statistically significant(P<0.05).In the control group,the air-bone gap difference before and after treatment was(21.79±5.83)dB HL and(10.58±3.37)dB HL,respectively,and the difference was statistically significant(P<0.05).There was no significant difference in the air-bone gap difference between the two groups after treatment(P>0.05).Conclusion The ear shield cartilage-bilateral cartilage membrane composite used for repairing large perforations of the tympanic membrane under ear endoscopy can reduce the difficulty of material acquisition during surgery and improve postoperative hearing.It is a reliable r

关 键 词：耳内镜 耳屏软骨-软骨膜复合体 鼓室成形术 鼓膜大穿孔 颞肌筋膜 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]