翻修鼓室成形术中的软骨“盾牌”移植术
Cartilage "shield" grafts in revision tympanoplasty.
作者信息
Sismanis Aristides, Dodson Kelley, Kyrodimos Efthymios
机构信息
Department of Otolaryngology, Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia, USA.
出版信息
Otol Neurotol. 2008 Apr;29(3):330-3. doi: 10.1097/mao.0b013e318161aae1.
OBJECTIVE
To report our experience with cartilage "shield" grafts in revision tympanoplasty.
STUDY DESIGN
Retrospective chart review at a tertiary referral center. Patients underwent revision tympanoplasties by replacing the entire tympanic membrane with concha cymba cartilage shaped as a shield.
MAIN OUTCOME MEASURES
Successful graft take was defined as having no perforation, graft retraction, or lateralization. Hearing results were analyzed by comparing the preoperative and postoperative pure-tone average air-bone gap and speech discrimination scores.
RESULTS
Forty-three patients underwent 46 procedures. Graft take was successful in 43 procedures (93.5%). There was no graft lateralization or displacement into the middle ear. An overall postoperative air-bone gap of 25 dB or less was achieved in 22 of the 39 patients (56.4%), and speech discrimination scores remained unchanged.
CONCLUSION
Cartilage shield tympanoplasty is a reliable procedure for revision tympanoplasty patients, with excellent graft take and significant improvement of hearing.
目的
报告我们在翻修鼓室成形术中使用软骨“盾牌”移植物的经验。
研究设计
在三级转诊中心进行回顾性图表审查。患者接受翻修鼓室成形术，用形状为盾牌的耳甲艇软骨替换整个鼓膜。
主要观察指标
移植物成功存活定义为无穿孔、移植物回缩或外移。通过比较术前和术后纯音平均气骨导差及言语辨别得分来分析听力结果。
结果
43例患者接受了46次手术。43次手术（93.5%）移植物存活成功。没有移植物外移或移入中耳。39例患者中有22例（56.4%）术后气骨导差总体达到25dB或更低，言语辨别得分保持不变。
结论
软骨盾牌鼓室成形术对于翻修鼓室成形术患者是一种可靠的手术方法，移植物存活良好，听力有显著改善。
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