Uslu Celil, Tek Arman, Tatlipinar Arzu, Kiliçarslan Yasin, Durmuş Ruhi, Ayöğredik Evren, Karaman Murat, Oysu Cağatay
Department of Otorhinolaryngology at Haydarpasa State Hospital for Research and Training, Istanbul, Turkey.
Acta Otolaryngol. 2010 Mar;130(3):375-83. doi: 10.3109/00016480903145346.
High risk perforations including total, subtotal, atelectatic perforations, those with cholesteatoma and revision cases can be treated efficiently with cartilage reinforcement tympanoplasty.
The purpose of this study was to describe the perforation closure rates and hearing results of cartilage reinforcement tympanoplasty.
This was a retrospective chart review and included 60 patients who underwent surgery with the cartilage reinforcement technique between November 2006 and October 2008 at the Department of Otorhinolaryngology of Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey. The male to female ratio was 28 (46.7%)/32 (53.3%). The mean age of the patients was 30.10 +/- 11.50 years (range 13-55).
Preoperatively, only one patient had a retraction pocket but not a perforation, 12 (20%) patients had perforation of < 25% of the total tympanic membrane diameter, 12 patients had perforation between 25% and 50% of the total membrane diameter, 18 patients had a perforation between 50% and 75% of total membrane diameter and 17 patients had a perforation of > 75% of the total membrane diameter. Postoperatively we achieved total closure of tympanic membrane perforations for 47 patients but the perforations of 13 patients remained in various sizes (7 patients had tympanic membrane perforation < 25% of the total membrane diameter, 3 between 25% and 50%, 2 between 50% and 75% and 1 patient had a perforation > 75% of the total membrane diameter). There was a statistically significant difference between percentages of preoperative perforation and postoperative perforations (p = 0.001). Only 1.7% of patients had no perforation preoperatively and this ratio increased to 78.3% postoperatively. Also, 30% of patients had a perforation between 50% and 75% of the total membrane diameter, 28.3% of the patients had a perforation > 75% of the total membrane diameter preoperatively and this ratio decreased to 3.3% and 1.7%, respectively. Concerning the audiological parameters, the difference between preoperative and postoperative hearing levels was statistically significant (p = 0.001).
包括全层、次全层、肺不张性穿孔、伴有胆脂瘤的穿孔以及翻修病例在内的高风险穿孔，可通过软骨强化鼓室成形术得到有效治疗。
本研究旨在描述软骨强化鼓室成形术的穿孔闭合率及听力结果。
这是一项回顾性病历审查研究，纳入了2006年11月至2008年10月期间在土耳其伊斯坦布尔海达尔帕萨努穆内研究与培训医院耳鼻喉科接受软骨强化技术手术的60例患者。男女比例为28例（46.7%）/32例（53.3%）。患者的平均年龄为30.10±11.50岁（范围13 - 55岁）。
术前，仅1例患者有内陷袋但无穿孔，12例（20%）患者穿孔面积小于鼓膜总面积的25%，12例患者穿孔面积在鼓膜总面积的25%至50%之间，18例患者穿孔面积在鼓膜总面积的50%至75%之间，17例患者穿孔面积大于鼓膜总面积的75%。术后，47例患者鼓膜穿孔完全闭合，但13例患者的穿孔仍有不同大小（7例患者鼓膜穿孔面积小于鼓膜总面积的25%，3例在25%至50%之间，2例在50%至75%之间，1例患者穿孔面积大于鼓膜总面积的75%）。术前穿孔百分比与术后穿孔百分比之间存在统计学显著差异（p = 0.001）。术前仅1.7%的患者无穿孔，术后这一比例增至78.3%。此外，术前30%的患者穿孔面积在鼓膜总面积的50%至75%之间，28.3%的患者穿孔面积大于鼓膜总面积的75%，术后这一比例分别降至3.3%和1.7%。关于听力学参数，术前和术后听力水平的差异具有统计学显著性（p = 0.001）。
