耳内镜下鼓耳道后径路行鼓膜修补术的疗效观察

目的探讨耳内镜下鼓耳道后径路行鼓膜修补术疗效观察。方法采用回顾性分析,对我科21例耳内镜下行鼓耳道后径路鼓膜修补患者,随访半年,针对术后鼓膜愈合率以及听力情况进行分析。结果20例患者,21耳,20例鼓膜愈合,成功率为95.2%,术后无味觉损伤,无移植物内陷及外移,无耳鸣或耳鸣加重,无听力损伤,无胆脂瘤形成;术前平均气导听阈为(49.4±8.6)dB HL,骨气导差为(31.9±4.9)dB HL,术后平均气导听阈为(24.2±5.9)dB HL,骨气导差为(12.7±6.5)dB HL,听力较术前明显提高(P<0.01)。17例(81%)骨气导差小于20db HL。结论耳内镜下利用耳屏软骨-软骨膜经鼓耳道后径路行鼓膜修补术,对不同部位鼓膜穿孔愈合率及听力恢复均获得良好疗效,临床上值得推广应用。

The clinical outcomes of otoendoscopic myringoplasty through posterior tympanomeatal flap elevations

Objective To investigate the clinical outcomes of otoendoscopic myringoplasty through posterior tympanomeatal flap elevations.Methods Twenty-one patients with tympanic membrane perforation were operated through posterior tympanomeatal flap elevations by otoendoscope,all followed up for at least half a year.The healing rate of tympanic membrane and hearing condition after operation were analyzed retrospectively.Results Twenty patients,21 ears and 20 tympanic membranes healed with a success rate of 95.2%.There was no taste sense damage,graft invagination or displacement,tinnitus or tinnitus aggravation,no hearing damage and no cholesteatoma formation after surgery.Preoperative air conduction and bone-air conduction gap in the study cohort were(49.4±8.6)dB HL and(31.9±4.9)dB HL respectively.Postoperative air conduction and bone-air conduction gap were(24.2±5.9)dB HL and(12.7±6.5)dB HL respectively.The postoperative hearing was significantly improved compared with preoperative hearing(P<0.01).Overall postoperative bone-air gaps in 17 of the 21 patients(81%)were less than 20db HL after surgery.Conclusion The procedure of endoscopic cartilage-perichondrium myringoplasty through posterior tympanomeatal flap elevations is effective in the treatment of tympanic membrane perforations with different parts,which is worth promotive and applicative in clinic.