Department of Ear, Nose and Throat, Hearing Loss Clinic, National Hospital Abuja, Plot 132, Central Area, Garki (Phase 2), Abuja 900001, FCT, Nigeria.
Eur Arch Otorhinolaryngol. 2011 Mar;268(3):367-72. doi: 10.1007/s00405-010-1405-x. Epub 2010 Oct 23.
The objective of this study is to determine the subjective and objective outcomes of tympanoplasty surgery carried out in patients with otitis media and to identify factors responsible for these outcomes. The study setting is tertiary care urban referral hospital in a developing economy and the study methodology is a prospective analysis of patients with diagnosis of chronic suppurative otitis media that had tympanoplasty with or without mastoidectomy between May 2005 and September 2009 at National Hospital Abuja. Subjects were evaluated for age, sex, size and site of perforation, status of operated ear(s) (dry/discharging), status of the contralateral ear, surgical technique, subjective and objective pre-operative and post-operative hearing scores, average post-operative follow-up time, and post-operative complications, and results were statistically analyzed. A total of 45 patients (51 ears) were operated. Age distribution was 8-52 years. Type 1 tympanoplasty was done in 41 patients and Type 3 in 4 patients. Seven of the patient had concomitant mastoid surgery (cortical mastoidectomy). 3/51 of the cases had discharging ears at surgery. 16/45 of the patients (19/51 ears) had cartilage graft tympanoplasty, while 29/45 (32 ears) had temporalis fascia tympanoplasty. 15/16 of the cartilage group as well as 26/29 of the fascia group reported subjective hearing improvement, whilst the actual graft take was 12/16 of the cartilage group and 23/29 of the fascia group. Objective hearing improvement was observed in all of the cartilage as well as 26/29 of the fascia group. This study confirms success of tympanoplasty among Nigerians, and recommends that subjective hearing assessment should form part of indicators for success following tympanoplasty.
本研究旨在确定中耳炎患者鼓室成形术的主观和客观结果，并确定这些结果的相关因素。研究地点为发展中国家的三级城市转诊医院，研究方法为对 2005 年 5 月至 2009 年 9 月期间在阿布贾国家医院接受慢性化脓性中耳炎伴或不伴乳突切除术的患者进行前瞻性分析。评估内容包括年龄、性别、穿孔大小和位置、手术耳（干燥/溢液）状况、对侧耳状况、手术技术、术前和术后的主观和客观听力评分、平均术后随访时间、术后并发症，并进行统计学分析。共有 45 名患者（51 耳）接受手术。年龄分布在 8-52 岁之间。41 例患者行 1 型鼓室成形术，4 例患者行 3 型鼓室成形术。7 例患者行乳突同期手术（皮质乳突切除术）。手术时有 3/51 耳溢液。16/45 例（19/51 耳）患者行软骨移植鼓膜成形术，29/45 例（32 耳）行颞肌筋膜鼓膜成形术。软骨组中有 15/16 例患者报告主观听力改善，而筋膜组中有 26/29 例患者报告主观听力改善，软骨组中有 12/16 例患者实际移植物存活，而筋膜组中有 23/29 例患者实际移植物存活。软骨组和筋膜组的所有患者均观察到客观听力改善。本研究证实了鼓室成形术在尼日利亚人中的成功率，并建议主观听力评估应成为鼓室成形术成功的指标之一。
