耳内镜下夹层法鼓膜成形术59例临床疗效分析  

Clinical analysis of 59 cases of myringoplasty with sandwich method under otoendoscope

作　　者：柯菊英 章莎莎 KE Juying;ZHANG Shasha(Department of Otolaryngology,Sanmen People's Hospital,Sanmen,Zhejiang,317100,China)

机构地区：[1]浙江省三门县人民医院耳鼻咽喉科,浙江三门317100

出　　处：《中国耳鼻咽喉头颈外科》2024年第7期431-434,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨耳内镜下夹层法鼓膜成形术的临床疗效。方法选取2019年1月~2022年8月收治的59例慢性化脓性中耳炎患者,采用耳内镜下夹层法鼓膜成形术,观察术后鼓膜愈合、听力改善程度及并发症等指标。结果总穿孔愈合率为98.3%(58/59),1例出现鼓膜前下部钝角愈合,1例发生鼓膜局部胆脂瘤珠。术前与术后1年平均言语频率气导听阈分别为(40.2±7.9)dB HL和(22.5±8.3)dB HL,差异有统计学意义(t=11.31,P<0.01);术前与术后1年平均言语频率气骨导差分别为(26.3±6.1)dB HL和(12.8±5.7)dB HL,差异有统计学意义(t=9.54,P<0.01)。结论耳内镜下夹层法鼓膜成形术兼具耳内镜和夹层法术式的各自优点,手术创伤少,符合微创原则,穿孔愈合率高,术后听力效果好,是一种理想的鼓膜穿孔修复术式。OBJECTIVE To explore the efficacy of otoscope assisted dissection myringoplasty.METHODS Fifty-nine patients with otitis media suppurative admitted from January 2019 to August 2022 were underwent otoscope assisted dissection myringoplasty.Tympanic membrane healing,hearing improvement,and complications were observed.RESULTS The total perforation healing rate was 98.3%(58/59).One case had obtuse angle healing at the anterior lower part of the tympanic membrane,and one case had local cholesteatoma beads on the tympanic membrane.The preoperative average speech frequency air conduction hearing threshold was(40.2±7.9)dB HL,and postoperative one year was(22.5±8.3)dB HL,with statistically significant differences(t=11.31,P<0.01);The preoperative average speech frequency and bone conduction was(26.3±6.1)dB HL,and postoperative one year was(12.8±5.7)dB HL,with statistically significant differences(t=9.54,P<0.01).CONCLUTION The mezzanine tympanoplasty under otoscopy owning the advantages of both otoscopy and mezzanine methods,have the outcomes of minimal damage,high healing rate,and postoperative hearing improvement.It is an ideal tympanoplasty for repairing perforation of tympanic membrane.

关 键 词：鼓膜穿孔 鼓膜成形术 耳内镜检查 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]