耳内镜下耳屏软骨-软骨膜修补鼓膜大穿孔临床疗效

目的探讨耳内镜下利用耳屏软骨-软骨膜修补鼓膜大穿孔的临床疗效。方法对我科收治的50例鼓膜穿孔的病人,采用自体耳屏软骨-软骨膜,在耳内镜下行Ⅰ型鼓室成形术,采用内衬法完成鼓膜修补。结果术后对50例患耳进行术后随访6~12个月,患者无耳鸣,气骨导听力下降,眩晕等。术后3个月复查,鼓膜穿孔愈合率为96%。术后一年复查无鼓膜再次穿孔,内陷,粘连,患者未诉听力下降。术前患者患耳平均听阈56.48 dB,术后3~6个月复查纯音测听,患者言语频率气导听力平均提高30.32 dB。患者术耳外观恢复良好,未见明显瘢痕增生及耳外形改变。结论耳内镜下耳屏软骨-软骨膜修补术操作相对简单,术野清晰,视野广,手术时间较短。且取自体耳屏软骨-软骨膜作为修补材料较方便,创伤小,符合美学标准。耳屏软骨-软骨膜抗感染能力强,听力恢复效果稳定。因此耳屏软骨-软骨膜是耳内镜下鼓膜大穿孔修补的最佳选择材料,值得推广。

Clinical effect of auricular cartilage and perichondrium repairing tympanic membrane perforation under otoscope

Objective To explore the clinical effect of repairing large perforation of tympanic membrane using tragus cartilage-chondral membrane under otoscope.Methods Fifty patients with perforation of the tympanic membrane treated in our department were treated with autologous tragus cartilage-the perichondrium,and performed tympanic tympanoplasty under the auricular endoscope.Results The postoperative follow-up was performed on 50 affected ears for 6~12 months.The patients had no tinnitus,decreased air-bone conduction hearing,and dizziness.After 3 months of review,the healing rate of tympanic membrane perforation was 96%.One year after the operation,there was no tympanic membrane perforation,subsidence,or adhesion.The patient did not report hearing loss.The average hearing threshold of the patients’ears before surgery was 56.48dB,and pure tone audiometry was reviewed 3 to 6 months after surgery.The average speech frequency of the patients increased by 30.32dB.The appearance of the patient’s ears recovered well,and no obvious hyperplasia of the scar and no change in the shape of the ears were observed.Conclusions Otoscope cartilage-perichondrial repair under otoscope is relatively simple,the operation field is clear,the field of vision is wide,and the operation time is short.And the cartilage from the tragus of the body-perichondrium is more convenient as a repairing material,less trauma,and meets the aesthetic standards,The tragus cartilage-chondrium has strong anti-infective ability and stable hearing recovery effect.Therefore,the tragus cartilage-chondral membrane is the best choice material for repair of large perforation of tympanic membrane under otoscope,and it is worth popularizing.