The Department of Otorhinolaryngology, Haydarpaşa Numune State Hospital for Research and Training, İstanbul, Turkey.
Eur Arch Otorhinolaryngol. 2012 Apr;269(4):1117-26. doi: 10.1007/s00405-011-1779-4. Epub 2011 Oct 4.
Our objective is to compare hearing and graft take results of temporal muscle fascia tympanoplasty and cartilage reinforcement tympanoplasty. Seventy seven patients are classified into two groups: Group 1 included 37 patients for whom cartilage graft, harvested from symba concha, is used as reinforcement under temporalis muscle fascia anteriorly and Group 2 included 40 patients for whom only temporalis muscle fascia is used in type 1 tympanoplasty. A pure-tone audiometry is done within 1 week prior to surgery and at 6 months postoperatively. There is statistically significant difference between postoperative graft take results among groups. In both groups postoperative anterior TM perforation is encountered most commonly. Success rate of cartilage reinforcement tympanoplasty in revision patients is 100% but temporal muscle fascia tympanoplasty's is 66%. There is no statistically significant difference between preoperative and postoperative air conduction gain of TM intact patients. The results indicated that Cartilage reinforcement myringoplasty technique under anterior of the temporal muscle fascia significantly increases the graft take ratios in high-risk perforations and it also does not affect hearing levels. Therefore, the authors suggest usage of cartilage reinforcement tympanoplasty technique under anterior of the temporal muscle fascia which is an easy and applicable technique to increase graft take ratios, particularly in patients with preoperative anterior and subtotal TM perforations.
我们的目的是比较颞肌筋膜鼓膜成形术和软骨增强鼓膜成形术的听力和移植物成活率。77 例患者分为两组：第 1 组 37 例患者，在前颞肌筋膜下使用取自 symba 贝壳的软骨作为增强物；第 2 组 40 例患者仅使用颞肌筋膜进行 1 型鼓膜成形术。术前 1 周和术后 6 个月进行纯音测听。各组之间的术后移植物成活率存在统计学差异。两组中，术后前 TM 穿孔最常见。翻修患者软骨增强鼓膜成形术的成功率为 100%，而颞肌筋膜鼓膜成形术为 66%。TM 完整患者术前和术后气导增益无统计学差异。结果表明，颞肌筋膜前软骨增强鼓膜成形术显著提高了高危穿孔的移植物成活率，且不影响听力水平。因此，作者建议使用颞肌筋膜前的软骨增强鼓膜成形术技术，该技术易于操作，可提高移植物成活率，特别是在术前有前 TM 和次全 TM 穿孔的患者中。
