Gérard J M, Decat M, Gersdorff M
ENT Department, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Bruxelles.
Acta Otorhinolaryngol Belg. 2003;57(2):147-50.
Management of chronic perforation and severe posterior and/or attic Retraction Pocket (RP) or atelectasis of the tympanic membrane continues to be one of the most difficult problems for otologists.
To analyse the usefulness of the tympanic membrane reconstruction with tragal cartilage.
The study included 27 patients with chronic perforation or severe RP operated by the same surgeon, using tragal cartilage tympanoplasty. Seven supplementary procedures were required for recurrent cholesteatoma (second-look surgery).
There has been no recurrence of the retraction and the perforation. Nineteen ossicular reconstructions were necessary with acceptable hearing results.
Tragal cartilage has made a significant improvement in the tympanic membrane reconstruction procedure. A large thin cartilage combined with a titanium prosthesis can provide an excellent anatomical result, perfect stability and good functional outcome. When the eardrum is intact, we still use allografts of costal cartilage for the management of the retraction pocket or titanium prosthesis.
慢性鼓膜穿孔以及严重的鼓膜后和/或上鼓室退缩袋(RP)或鼓膜萎缩的处理,仍然是耳科医生面临的最棘手问题之一。
分析采用耳屏软骨进行鼓膜重建的有效性。
本研究纳入了27例由同一位外科医生采用耳屏软骨鼓室成形术治疗的慢性穿孔或严重RP患者。因复发性胆脂瘤(二次探查手术)需进行7次补充手术。
退缩和穿孔均未复发。19例患者需要进行听骨链重建,听力结果尚可接受。
耳屏软骨显著改善了鼓膜重建手术。一块大的薄软骨联合钛质假体可提供优异的解剖学效果、完美的稳定性和良好的功能结果。当鼓膜完整时,我们仍使用肋软骨同种异体移植物来处理退缩袋或钛质假体。