耳屏岛状软骨-软骨膜在鼓膜成形术中的应用

目的探讨采用耳屏岛状软骨-软骨膜修补鼓膜大穿孔的手术方法及临床效果。方法64例（64耳）鼓膜穿孔患者用耳屏岛状软骨-软骨膜行鼓膜修复，所有患者均采用内植法一期完成手术。术后1年复查耳内镜及纯音听阈，并对结果进行分析。结果所有患者术后无耳鸣加重、无眩晕、无面瘫等。除1例鼓膜再穿孔外，余均愈合，愈合率为98．4％（63／64）；术后1年复查纯音测听语言频率平均气导听阈为29．1dB（术前为38．3dB），骨气导差距平均为13．4dB（术前为24．6dB），手术前后比较差异均具有统计学意义（P〈0．05）。结论耳屏岛状软骨-软骨膜修复鼓膜穿孔是一种可靠的方法，尤其适合于鼓膜大穿孔、复发性穿孔患者。

Application of island shaped tragal cartilage perichondrium to myringoplast

Objective To investigate the methodology and clinical effect of island-shaped tragal cartilageperichondrium for repair of large perforation of tympanic membrane. Methods The composite of island-shaped tragal cartilage-perichondrium was used for repair of perforation of tympanic membrane with interplantation method in 64 patients （64 ears ）. All patients received otoscopy and pure tone andiometry one year after operation. Results All the 64 patients were followed up more than one year postoperatively. No vertigo, facial palsy or exacerbation of tinnitus occurred in all the patients. Recurrent perforation was observed in one case. The healing rate was 98.4% （63/64）. Pure tone audiometry showed that the average air conduction thresholds among speech frequencies before and after myringoplasty were 38. 3 dB and 29. 1 dB with average air bone gap of 24. 6 dB and 13. 4 dB respectively. Their differences were statistically significant （ P 〈 0. 05 ）. Conclusion Myringoplasty with islandshaped tragal cartilage-perichondria is a reliable method to repair perforation of tympanic membrane, especially large or recurrent perforation.