Department of Otolaryngology, General Hospital of Larnaca, Larnaca, Cyprus.
J Otolaryngol Head Neck Surg. 2012 Feb;41(1):14-9.
To evaluate the effect of type I chondrotympanoplasty on the resonant frequency (RF) of the middle ear and compare it to the respective outcomes of type I tympanoplasty using temporalis fascia grafting (TFG). Hearing results and respective graft integration rates were also assessed.
A retrospective comparative study was conducted of patients who had undergone type I tympanoplasty at a tertiary university hospital. Selection criteria included tympanic membrane perforation following chronic otitis media, trauma, or grommet insertion; an intact ossicular chain; a dry ear for at least 3 months; and normal middle ear mucosa. Patients with ossicular discontinuity, ossiculoplasty, cholesteatoma, previous ear surgery, syndromes affecting the middle ear, or younger than 16 years old were excluded.
Sixty-nine patients met the inclusion criteria; chondrotympanoplasty was performed in 39 and TFG in 30. Three patients showed incomplete tympanic membrane closure at follow-up. The graft integration rate was 97.4% in the chondrotympanoplasty group and 93.3% in the TFG group. An air-bone gap closure within 10 dB was achieved in 73.7% of the chondrotympanoplasty patients versus 67.9% of the TFG patients. Hearing gain of 21 to 30 dB in air conduction thresholds was obtained in 65.8% of the chondrotympanoplasty patients and 60.7% of their TFG counterparts. RF was 808 ± 458 Hz in the chondrotympanoplasty group and 628 ± 256 Hz in the TFG group. The RF remained within the normal range in 73.7% of chondrotympanoplasty patients versus 42.9% of TFG patients.
Chondrotympanoplasty has hearing results comparable to those of TFG myringoplasty. The cartilage can be used without concerns regarding its impact on the middle ear mechanics as the sound-conducive properties of the tympanic membrane remain unchanged.
评估 I 型鼓室成形术对中耳共振频率（RF）的影响，并将其与使用颞肌筋膜移植物（TFG）的 I 型鼓室成形术的相应结果进行比较。还评估了听力结果和各自的移植物整合率。
对在一家三级大学医院接受 I 型鼓室成形术的患者进行了回顾性比较研究。入选标准包括慢性中耳炎、创伤或鼓膜置管后鼓膜穿孔；完整的听小骨链；至少 3 个月干耳；和正常的中耳黏膜。排除有听小骨连续性中断、听小骨成形术、胆脂瘤、既往耳部手术、影响中耳的综合征或年龄小于 16 岁的患者。
69 例患者符合纳入标准；39 例患者行软骨成形术，30 例患者行 TFG。3 例患者在随访时出现鼓膜不完全闭合。软骨成形术组的移植物整合率为 97.4%，TFG 组为 93.3%。软骨成形术组中有 73.7%的患者气骨导差在 10dB 以内闭合，TFG 组为 67.9%。空气传导阈值听力增益为 21 至 30dB 的患者，软骨成形术组为 65.8%，TFG 组为 60.7%。软骨成形术组的 RF 为 808±458Hz，TFG 组为 628±256Hz。软骨成形术组中有 73.7%的患者 RF 在正常范围内，而 TFG 组只有 42.9%的患者 RF 在正常范围内。
软骨成形术的听力结果与 TFG 鼓膜成形术相当。软骨可以放心使用，不用担心其对中耳力学的影响，因为鼓膜的传音性能保持不变。
