Yetişer Sertaç, Karapınar Uğur
Department of Otolaryngology, Anadolu Medical Center, Kocaeli, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2011 Jul-Aug;21(4):179-83. doi: 10.5606/kbbihtisas.2011.023.
In this study we investigated the correlation between middle ear pressure changes in patients with myringoplasty alone and together with intact canal wall mastoidectomy.
The tympanometric values of 102 patients with myringoplasty alone and 78 patients with myringoplasty plus intact canal wall mastoidectomy were examined by tympanometric analysis in this retro-prospective study. The study population consisted of 130 male and 50 female patients (mean age 25.3±7.7). All patients underwent myringoplasty with or without mastoidectomy due to chronic otitis without cholesteatoma. Patients with a value of less than -100 daPa during the postoperative follow-up were considered having normal middle ear ventilation. Independent-samples t-test was used for comparison of the analyses results of groups.
Sixty patients with myringoplasty (58.8%) and 55 patients with intact canal wall mastoidectomy (70.5%) had middle ear pressures less than -100 daPa at three months after surgery. The percentage of recovery over the first three years was 70.5% and 76.9% in the myringoplasty and intact canal wall mastoidectomy groups, respectively. The rate of persistent negative pressure is 21.6% and 14.1% in the myringoplasty and intact canal wall mastoidectomy groups, respectively. The number of patients who had negative middle ear pressure in myringoplasty group was higher than the number of those in intact canal wall mastoidectomy group at all intervals. However, when the rate of normalization over time was compared between two groups, no significant difference was found (p>0.05).
In first three months, the significantly higher number of patients achieving normal middle ear ventilation in mastoidectomy group compared to the patients without mastoidectomy is a finding which supports the additional effect of mastoidectomy on the pressure normalization function. However, the rate of normalization over time is not different between two groups. Middle ear pressure normalization is a continuous dynamic process and improvements may be seen for up to one year.
在本研究中，我们调查了单纯鼓膜成形术患者以及联合完整外耳道壁乳突切除术患者中耳压力变化之间的相关性。
在这项回顾性前瞻性研究中，通过鼓室图分析检查了102例单纯鼓膜成形术患者和78例鼓膜成形术加完整外耳道壁乳突切除术患者的鼓室图值。研究人群包括130名男性和50名女性患者（平均年龄25.3±7.7岁）。所有患者均因无胆脂瘤型慢性中耳炎接受了鼓膜成形术，部分患者还接受了乳突切除术。术后随访期间中耳压力值小于-100 daPa的患者被认为中耳通气正常。采用独立样本t检验比较两组的分析结果。
单纯鼓膜成形术组60例患者（58.8%）和完整外耳道壁乳突切除术组55例患者（70.5%）在术后三个月时中耳压力小于-100 daPa。在鼓膜成形术组和完整外耳道壁乳突切除术组中，前三年的恢复率分别为70.5%和76.9%。持续性负压率在鼓膜成形术组和完整外耳道壁乳突切除术组中分别为21.6%和14.1%。在所有随访时间点，鼓膜成形术组中耳压力为负压的患者数量均高于完整外耳道壁乳突切除术组。然而，比较两组随时间的正常化率时，未发现显著差异（p>0.05）。
在术后前三个月，与未行乳突切除术的患者相比，乳突切除术组中耳通气正常的患者数量显著更多，这一发现支持了乳突切除术对压力正常化功能的额外作用。然而，两组随时间的正常化率并无差异。中耳压力正常化是一个持续的动态过程，长达一年可能都可见到改善。
