Labatut Pesce Tomás, Sierra Grañon Cristina, Mora Rivas Elena, Cobeta Marco Ignacio
Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Acta Otorrinolaringol Esp. 2009 Mar-Apr;60(2):79-83.
The goals of myringoplasty are closure of the perforation in the tympanic membrane and improvement in hearing levels, with varying results in the published literature. Our aim was to determine the results of this procedure at our centre and compare them with the literature.
Retrospective analysis of 217 primary myringoplasties carried out in the Otorhinolaryngology Department of the Ramón y Cajal University Hospital between 1998 and 2003, describing the characteristics of the perforations, surgical technique and post-operative results (perforation closure and hearing improvement).
The majority were adults with perforations secondary to recurrent middle ear infections (91%). Most were less than subtotal (64%) and did not involve the tympanic annulus (79%). Grafts were inserted using lateral (45%), mixed (29%) and medial (26%) techniques, using retroauricular (66%) and endaural (34%) approaches. Temporal muscle fascia was the graft most frequently used (87%). Perforation closure was achieved in between 78% and 91% of cases throughout the 24-month follow-up period, with an overall closure value of 78% after 2 years of follow-up. Hearing improvement, established as an air bone gap difference of less than 20 dB, was seen in approximately 56% of cases.
At our centre, myringoplasty achieves anatomical (78%) and functional (56%) success comparable to the results described in the literature. We consider medium-term follow-up to be of the utmost importance because of reperforation phenomena, which may occur as much as 2 years or more after surgery.
鼓膜成形术的目标是封闭鼓膜穿孔并提高听力水平，然而在已发表的文献中结果各异。我们的目的是确定该手术在我们中心的效果，并与文献进行比较。
回顾性分析1998年至2003年间在拉蒙·y·卡哈尔大学医院耳鼻喉科进行的217例原发性鼓膜成形术，描述穿孔的特征、手术技术及术后结果（穿孔封闭和听力改善情况）。
大多数为成年人，穿孔继发于复发性中耳感染（91%）。大多数穿孔小于次全穿孔（64%），且未累及鼓膜环（79%）。采用外侧（45%）、混合（29%）和内侧（26%）技术植入移植物，采用耳后（66%）和耳道内（34%）入路。颞肌筋膜是最常用的移植物（87%）。在整个24个月的随访期内，78%至91%的病例实现了穿孔封闭，随访2年后总体封闭率为78%。约56%的病例听力得到改善，定义为气骨导差小于20dB。
在我们中心，鼓膜成形术在解剖学上（78%）和功能上（56%）取得了成功，与文献中描述的结果相当。由于再穿孔现象可能在术后2年或更长时间出现，我们认为中期随访至关重要。
