耳内镜下夹层法鼓膜成形术治疗鼓膜大穿孔的临床研究

目的探讨耳内镜下夹层法鼓膜成形术治疗鼓膜大穿孔的临床疗效。方法回顾性分析该科在2017年1月-2017年10月对18例患者的21侧鼓膜大穿孔进行耳内镜下夹层法鼓膜成形术,统计分析手术时间、出血量,术后6个月随访观察鼓膜愈合情况,比较术前和术后的听力情况。结果21侧患耳平均手术时间(44.95±8.50)min,手术平均出血量(19.19±3.16)ml。19侧鼓膜完全愈合,鼓膜成形术成功率为90.48%;2侧鼓膜完全愈合后因真菌感染再次穿孔。术后6个月的平均气导听阈、平均气骨导差较术前下降,差异有统计学意义(P<0.05)。结论耳内镜下夹层法鼓膜成形术治疗鼓膜大穿孔具有创伤小、恢复快和疗效好的优点,是一种值得推广的手术方法。

Clinical study of interlayer myringoplasty via endoscope in large perforation of tympanic membrane

Objective To investigate the therapeutic effect in treatment of large tympanic membrane perforation by endoscopic sandwiching myringoplasty.Methods Retrospective analysis from January 2017 to October 2017,18 patients with 21 sides large perforation of tympanic membrane were subjected to endotoscopic tympanoplasty with Sandwiching,the operative duration and blood loss were statistically analyzed.The patients were followed up within 6 months after tympanoplasty,the condition of tympanic membrane was observed,and the preoperative and postoperative hearing conditions were compared.Results The average operative time was(44.95±8.50)min,and the average operative blood loss was(19.19±3.16)ml.19 sides tympanic membrane completely healing,the success rate of tympanoplasty was 90.48%.2 sides tympanic membrane was perforated again due to fungal infection after completely healing.Postoperative 6 month the mean airway auditory threshold and air-bone gaps were lower than those of preoperative,and the difference was statistically significant(P﹤0.05).Conclusions The study suggested that endoscopic sandwiching of myringoplasty is a safe surgical method with high graft success and effective hearing reconstruction in large tympanic membrane perforation.It is worthy of clinical promotion.