Sakagami M, Mishiro Y, Tsuzuki K, Seo T, Sone M
Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya City, Japan.
Auris Nasus Larynx. 2000 Jan;27(1):35-8. doi: 10.1016/s0385-8146(99)00043-7.
Bilateral same day surgery has been performed rarely because of the risk of postoperative sensorineural hearing loss following conventional myringoplasty or tympanoplasty (CMT). Simple underlay myringoplasty (SUM) through the ear canal has been developed by Yuasa R, Saijo S, Tomioka Y, et al. Office closure of eardrum perforation with fibrin glue (in Japanese), Otolaryngol Head Neck Surg (Tokyo) 1989;61:1117-1122, which has little risk of sensorineural hearing loss. We tried bilateral same day surgery using this technique and evaluated its outcome.
Of 86 cases with bilateral perforated chronic otitis media that we treated between 1995-1997, 25 cases underwent bilateral same day surgery. Bilateral SUMs was performed on seven patients, SUM and CMT on 16 patients, and bilateral CMTs on two patients.
Closure of perforation was successful in 18 patients (72%) on both sides and in seven patients (28%) on one side. Postoperative air-bone gap of less than 20 dB was achieved in 15 cases (60%) on both sides and in 23 cases (92%) on one side.
Bilateral same day surgery for bilateral perforated chronic otitis media is possible if the operative indications are considered.
由于传统鼓膜成形术或鼓室成形术(CMT)后存在感音神经性听力损失的风险,双侧同日手术很少进行。汤浅R、西条S、富冈Y等人开发了经耳道的简单夹层鼓膜成形术(SUM)。《用纤维蛋白胶进行鼓膜穿孔的门诊封闭(日文)》,《东京耳鼻咽喉头颈外科》1989年;61:1117 - 1122,该方法感音神经性听力损失风险很小。我们尝试使用该技术进行双侧同日手术并评估其结果。
在1995 - 1997年我们治疗的86例双侧慢性中耳炎穿孔患者中,25例接受了双侧同日手术。7例患者进行了双侧SUM手术,16例患者进行了SUM和CMT手术,2例患者进行了双侧CMT手术。
双侧穿孔闭合成功的有18例患者(72%),单侧成功的有7例患者(28%)。双侧术后气骨导差小于20dB的有15例(60%),单侧有23例(92%)。
如果考虑手术适应证,双侧慢性中耳炎穿孔的双侧同日手术是可行的。