Fishman Andrew J, Marrinan Michelle S, Huang Tina C, Kanowitz Seth J
Department of Otolaryngology, New York University School of Medicine, New York University Medical Center, NY 10016, USA.
Otolaryngol Head Neck Surg. 2005 Jun;132(6):906-15. doi: 10.1016/j.otohns.2004.12.013.
Patients who require surgery for chronic otitis media with perforation and cholesteatoma frequently provide no residual tympanic membrane that is usable in grafting procedures. A novel technique of total tympanic membrane reconstruction (TTMR) is described that maximizes perforation closure rate in these situations while minimizing mucosalization, incomplete healing, and anterior blunting. The specific aim of this report is to assess the safety and efficacy of TTMR and to compare the results obtained with AlloDerm compared with temporalis fascia as a grafting material.
The records of 50 patients operated within the years 1999 and the 2004 were reviewed. TTMR with intact canal wall was performed in all cases. Both clinical and audiometric data were analyzed.
Overall perforation closure rate was 92%. There was no statistical significance in closure rate when grafting with AlloDerm versus temporalis fascia. A statistically significant shortened healing time was observed with AlloDerm grafting.
TTMR is a highly effective and safe technique.
因慢性中耳炎伴穿孔及胆脂瘤而需要手术的患者，常常没有可用于移植手术的残余鼓膜。本文描述了一种全新的全鼓膜重建（TTMR）技术，该技术能在这些情况下最大化穿孔闭合率，同时将黏膜化、愈合不全及前部钝圆的情况降至最低。本报告的具体目的是评估TTMR的安全性和有效性，并比较使用脱细胞真皮基质（AlloDerm）与颞肌筋膜作为移植材料所获得的结果。
回顾了1999年至2004年间接受手术的50例患者的记录。所有病例均采用完整外耳道壁的TTMR。对临床和听力数据进行了分析。
总体穿孔闭合率为92%。使用AlloDerm与颞肌筋膜进行移植时，闭合率无统计学差异。观察到使用AlloDerm移植时愈合时间有统计学意义的缩短。
TTMR是一种高效且安全的技术。
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