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不同大小和位置鼓膜穿孔的脂肪移植鼓膜成形术的临床疗效

Clinical efficacy of fat-graft myringoplasty for perforations of different sizes and locations.

作者信息

Kim Dong-Kee, Park Shi-Nae, Yeo Sang Won, Kim Eun Hye, Kim Ji-Eun, Kim Boo-Young, Kim Min-Ji, Park Kyoung-Ho

机构信息

Department of Otolaryngology-Head & Neck Surgery, Catholic University of Korea, Seoul, Korea.

出版信息

Acta Otolaryngol. 2011 Jan;131(1):22-6. doi: 10.3109/00016489.2010.499881. Epub 2010 Aug 24.

Abstract

CONCLUSION

Fat-graft myringoplasty (FGM) has a reliable tympanic closure rate for small to large perforations, but yields poor hearing improvement in the latter case. A topographic evaluation of FGM showed that the procedure resulted in a reliable perforation closure rate and audiologic outcome, regardless of perforation location.

OBJECTIVES

This study assessed the utility of FGM in treating perforations of different sizes and locations.

METHODS

This retrospective study involved 45 patients (46 ears) who underwent FGM at St Mary's Hospital (Seoul, Korea) between August 2007 and February 2010.

RESULTS

The total perforation closure rate after FGM was 87% (40 cases), with no statistical difference among perforation size groups, even though the mean closure rates of the 10-20% and >30% perforation groups were lower than other groups. The difference in the closure rates of patients with anteriorly located perforations and those with perforations in other sites was not significant. The mean postoperative air-bone gap (ABG) was 14.3 (±7.5) dB. Mean postoperative ABG improved significantly after FGM; however, on a per-group basis, the >30% perforation group had the poorest results and the difference was statistically significant. The difference in mean postoperative ABGs of the two groups depending on the location of the perforation (anterior and other) was not significant.

摘要

结论

脂肪移植鼓膜成形术(FGM)对于中小至大穿孔具有可靠的鼓膜闭合率,但在后一种情况下听力改善效果不佳。FGM的地形学评估表明,无论穿孔位置如何,该手术都能带来可靠的穿孔闭合率和听力学结果。

目的

本研究评估FGM在治疗不同大小和位置穿孔方面的效用。

方法

这项回顾性研究纳入了2007年8月至2010年2月期间在韩国首尔圣玛丽医院接受FGM的45例患者(46耳)。

结果

FGM后的总穿孔闭合率为87%(40例),穿孔大小组之间无统计学差异,尽管10%-20%和>30%穿孔组的平均闭合率低于其他组。穿孔位于前方的患者与穿孔位于其他部位的患者的闭合率差异不显著。术后平均气骨导间距(ABG)为14.3(±7.5)dB。FGM术后平均ABG有显著改善;然而,按组分析,>30%穿孔组的结果最差,差异具有统计学意义。两组术后平均ABG因穿孔位置(前方和其他)的不同而无显著差异。

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