不同修补材料用于耳内镜下Ⅰ型鼓室成形术的临床疗效比较  

Comparison of clinical efficacy of different repair materials for typeⅠtympanoplasty under otoscopy

作　　者：詹斌 白彩恋 陈颖 高凯 太俊虎 ZHAN Bin;BAI Cailian;CHEN Ying;GAO Kai;TAI Junhu(Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xiamen Medical College,Fujian,Xiamen 361021,China)

机构地区：[1]厦门医学院附属第二医院耳鼻咽喉头颈外科,福建厦门361021

出　　处：《中国医药科学》2025年第2期122-125,167,共5页China Medicine And Pharmacy

基　　金：福建省厦门市医疗卫生指导性项目(3502Z20244ZD1267)。

摘　　要：目的比较耳内镜下应用不同修补材料行Ⅰ型鼓室成形术的临床疗效。方法回顾性分析2020年2月至2023年2月就诊于厦门医学院附属第二医院耳鼻咽喉头颈外科的90例(90耳)慢性化脓性中耳炎(CSOM)患者,共分为三组。A、B、C三组患者各30例,分别接受过耳内镜下经外耳道入路颞肌筋膜内置法Ⅰ型鼓室成形术、耳内镜下经外耳道入路耳屏软骨膜内置法Ⅰ型鼓室成形术、耳内镜下经外耳道入路耳屏软骨-软骨膜复合物内置法Ⅰ型鼓室成形术。比较三组患者术后1年的听力改善程度、耳鸣改善及鼓膜愈合情况。结果三组患者术后听力及耳鸣较术前均有改善(P<0.05),三组间在听力改善及术后并发症的发生上差异无统计学意义(P>0.05)。结论耳内镜下颞肌筋膜、软骨膜及软骨-软骨膜修补鼓膜穿孔的疗效相当,三种术式均有较高的鼓膜修补愈合率,值得临床推广。Objective To compare the clinical efficacy of typeⅠtympanoplasty using different repair materials under otoscopy.Methods A retrospective analysis was conducted on 90 patients(90 ears)with chronic suppurative otitis media(CSOM)who visited the Department of Otolaryngology Head and Neck Surgery of the Second Affiliated Hospital of Xiamen Medical College from February 2020 to February 2023.They were divided into three groups.30 patients in each Group A,B and C underwent typeⅠtympanoplasty using the temporal fascia insertion method through the external auditory canal under otoscopy,typeⅠtympanoplasty using the method of embedding the tragus cartilage membrane through the external auditory canal under otoscopy,typeⅠtympanoplasty using the method of embedding the tragus cartilage-cartilage membrane composite through the external auditory canal under otoscopy.The degree of hearing improvement,tinnitus improvement,and tympanic membrane healing among three groups of patients were compared one year after surgery.Results The postoperative hearing and tinnitus of all three groups of patients improved compared to preoperative levels(P<0.05),and there was no statistically significant difference in hearing improvement and postoperative complications among the three groups(P>0.05).Conclusion The efficacy of repairing tympanic membrane perforation with temporal fascia,cartilage membrane,and cartilage membrane under otoscopy is comparable,and all three surgical procedures have a high healing rate for tympanic membrane repair,which is worthy of clinical promotion.

关 键 词：慢性化脓性中耳炎 耳内窥镜手术 鼓膜修补 颞肌筋膜 耳屏软骨 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]