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鼓膜修补术(上鼓室-下鼓室法)

Over-under myringoplasty.

作者信息

Ahmed Zafar, Aslam Muhammad Azeem, Aslam Muhammad Javaid, Sharif Atif, Ahmed Malik Iftikhar

机构信息

Department of ENT, Foundation University Medical College, Rawalpindi.

出版信息

J Coll Physicians Surg Pak. 2005 Dec;15(12):768-70.

Abstract

OBJECTIVE

To determine the success rate of over-under technique of myringoplasty regarding rate of graft take, complications and hearing improvement.

DESIGN

Quasi-experimental study.

PLACE AND DURATION OF STUDY

Department of Otorhinolaryngology and Head and Neck Surgery, Fauji Foundation Hospital, Rawalpindi from March 2003 to January 2005.

PATIENTS AND METHODS

A total of 68 patients having dry central tympanic membrane perforations of various sizes secondary to chronic tubotympanic suppurative otitis media were included in the study. Over-under technique of myringoplasty was used to repair the tympanic membrane perforation. Outcome measures were graft success i.e., full or partial take, no perforation, atelactasis or lateralization within 6 months of operation and improvement in hearing.

RESULTS

Sixtysix patients (97%) out of 68 had full graft take at six months of follow-up. Only one (1.5%) met with graft failure and another one (1.5%) had partial graft take. Delayed perforation was noted in two patients (3%), both of these were 10 months after surgery. Atelactasis was seen in only one patient (1.5%) eight months after operation. Lateralization did not occur in any patient. Hearing improvement was noticed in 67 (98.5%) patients. Average air bone gap decreased by 12.65 dB.

CONCLUSION

Over-under myringoplasty is an effective technique of repairing the tympanic membrane perforation due to high rate of graft take, few complications and marked hearing improvement.

摘要

目的

确定鼓膜成形术的上下技术在移植物成活率、并发症及听力改善方面的成功率。

设计

准实验研究。

研究地点及时间

2003年3月至2005年1月在拉瓦尔品第的福吉基金会医院耳鼻咽喉头颈外科。

患者及方法

本研究纳入了68例因慢性咽鼓管鼓室化脓性中耳炎导致不同大小干性中央鼓膜穿孔的患者。采用鼓膜成形术的上下技术修复鼓膜穿孔。观察指标为移植物成功情况,即术后6个月内完全或部分成活、无穿孔、无肺不张或鼓室硬化,以及听力改善情况。

结果

68例患者中,66例(97%)在随访6个月时移植物完全成活。仅1例(1.5%)移植物失败,另1例(1.5%)移植物部分成活。2例患者(3%)出现延迟穿孔,均在术后10个月。仅1例患者(1.5%)在术后8个月出现肺不张。无患者出现鼓室硬化。67例(98.5%)患者听力得到改善。平均气骨导差下降了12.65 dB。

结论

上下鼓膜成形术是一种修复鼓膜穿孔的有效技术,因其移植物成活率高、并发症少且听力改善显著。

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