Sakagami M, Yuasa R, Yuasa Y
Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya City, Hyogo, Japan.
J Laryngol Otol. 2007 Sep;121(9):840-4. doi: 10.1017/S0022215106005561. Epub 2006 Dec 14.
To introduce simple underlay myringoplasty which is widely performed in Japan.
391 ears with perforated eardrum underwent simple underlay myringoplasty from 2000 to 2004, and which were followed up for more than six months after surgery.
After removing the margin of the perforation by a transcanal approach under local anaesthesia, a connective tissue graft was inserted through the perforation and lifted to contact the edge. Fibrin glue was dropped on the contact area. There was no packing in the canal or in the middle-ear cavity. If the perforation remained, re-closure was attempted using the patient's frozen tissue.
The rate of closure after the initial attempt was 304/391 (77.7 per cent), and that after re-closure for unsuccessful cases was 70/87 (80.5 per cent). The overall rate was 374/391 (95.7 per cent). There were no serious complications such as sensorineural hearing loss.
Simple underlay myringoplasty is a simple and minimally invasive procedure employing fibrin glue and has led to a high closure rate of the eardrum.
介绍在日本广泛开展的简易内植法鼓膜成形术。
2000年至2004年期间，391例鼓膜穿孔患者接受了简易内植法鼓膜成形术，并在术后进行了超过6个月的随访。
在局部麻醉下，经耳道 approach 切除穿孔边缘后，将结缔组织移植物通过穿孔插入并抬起以接触边缘。在接触区域滴入纤维蛋白胶。耳道或中耳腔内不进行填塞。如果穿孔仍然存在，则尝试使用患者的冷冻组织进行再次封闭。
初次尝试后的封闭率为304/391（77.7%），未成功病例再次封闭后的封闭率为70/87（80.5%）。总体封闭率为374/391（95.7%）。未出现诸如感音神经性听力损失等严重并发症。
简易内植法鼓膜成形术是一种采用纤维蛋白胶的简单且微创的手术方法，鼓膜封闭率高。
