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在紧张部胆脂瘤治疗中,环形软骨-软骨膜移植与“奔驰形”软骨-软骨膜移植鼓室成形术的比较

Ring versus 'Mercedes-Benz' cartilage-perichondrium graft tympanoplasty in management of pars tensa cholesteatoma.

作者信息

Albirmawy O A

机构信息

Otolaryngology Department, Tanta University Hospital, Egypt.

出版信息

J Laryngol Otol. 2011 Dec;125(12):1232-8. doi: 10.1017/S0022215111002593. Epub 2011 Sep 29.

Abstract

OBJECTIVE

To compare anatomical and audiological outcomes of ring versus 'Mercedes-Benz' cartilage-perichondrium graft tympanoplasty in patients with pars tensa cholesteatoma.

STUDY DESIGN

Prospective clinical study.

SETTING

Otolaryngology department, Tanta University Hospital, Egypt.

PATIENTS AND METHODS

Over three years, 60 ears in 60 patients underwent surgery for either sinus or tensa retraction cholesteatoma, reconstructed using either a ring-shaped (30 ears) or Mercedes-Benz symbol shaped (30 ears) cartilage-perichondrium graft, with at least two years' follow up. Post-operative drum perforation and retraction, cholesteatoma residue and recurrence, middle-ear effusion, and hearing acuity were monitored.

RESULTS

Anatomical outcomes were equivalent in both groups, but slightly better in the Mercedes group. Hearing improved significantly in both groups (pre- vs post-operative results), but significantly more so in the ring group. Within-group hearing outcomes were unaffected by cholesteatoma type or tympanoplasty type.

CONCLUSION

The Mercedes-Benz technique may be superior to the ring technique in preventing neodrum retraction. However, the ring graft technique had better hearing outcomes, perhaps due to its more physiological design.

摘要

目的

比较环形与“梅赛德斯 - 奔驰”型软骨 - 软骨膜移植鼓室成形术治疗紧张部胆脂瘤患者的解剖学和听力学结果。

研究设计

前瞻性临床研究。

研究地点

埃及坦塔大学医院耳鼻喉科。

患者与方法

三年间,60例患者的60耳因窦或紧张部内陷性胆脂瘤接受手术,分别采用环形(30耳)或梅赛德斯 - 奔驰标志形(30耳)软骨 - 软骨膜移植进行重建,并进行至少两年的随访。监测术后鼓膜穿孔和内陷、胆脂瘤残留和复发、中耳积液以及听力。

结果

两组的解剖学结果相当,但梅赛德斯组稍好。两组听力均显著改善(术前与术后结果相比),但环形组改善更为显著。组内听力结果不受胆脂瘤类型或鼓室成形术类型的影响。

结论

在预防新鼓膜内陷方面,梅赛德斯 - 奔驰技术可能优于环形技术。然而,环形移植技术的听力结果更好,这可能归因于其更符合生理的设计。

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