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脂肪移植鼓膜成形术联合新型手术技术治疗慢性鼓膜穿孔。

Fat graft myringoplasty with the newly developed surgical technique for chronic tympanic membrane perforation.

机构信息

Department of Otorhinolaryngology, Gaziosmanpasa University School of Medicine, Tokat, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2013 May;270(5):1629-33. doi: 10.1007/s00405-012-2040-5. Epub 2012 Sep 15.

Abstract

The purpose of this prospective clinical trial was to evaluate the success rate of our newly developed surgical technique for fat graft myringoplasty (FGM). We also aimed to assess the correlations between the size of perforations and closure rates, as well as the results of re-gained hearing in successful cases with respect to sizes of perforations. Thirty consecutive patients with persistent tympanic membrane perforation were included in this study. All patients underwent fat graft myringoplasty with a newly developed technique. Treatment success was defined as an intact tympanic membrane (TM) at the 3-month follow-up visit. Bone conduction (BC) and air conduction (AC) thresholds at the frequencies of 0.5, 1, 2, 3, and 4 kHz were recorded preoperatively and at the 3rd month postoperatively. The range of perforation sizes among the 30 patients was 7 mm in 13 of the patients (43 %), 6 mm in 8 of the patients (27 %), and 5 mm in nine of the patients (30 %). Closure of tympanic membrane perforations with this new technique was achieved in 27 out of the 30 patients, with a success rate of 90 %. The average of the air-bone gap (dB) was similar in preoperative and postoperative periods for 5- and 6-mm sized perforation groups (p = 0.09 and p = 0.49). However, in the 7-mm sized perforation group, the average of the air-bone gap (dB) was higher in the preoperative period than the postoperative period (p = 0.004). The average of the air-bone gap (dB) for all patients was higher in the preoperative period than the postoperative period (p = 0.001). In conclusion, FGM performed with this technique may be used as an alternative for the closure of tympanic membrane perforations larger than 5 mm.

摘要

本前瞻性临床试验旨在评估我们新开发的脂肪移植鼓膜成形术 (FGM) 外科技术的成功率。我们还旨在评估穿孔大小与闭合率之间的相关性,以及成功病例中听力恢复与穿孔大小之间的相关性。本研究纳入了 30 例连续的持续性鼓膜穿孔患者。所有患者均采用新开发的技术行脂肪移植鼓膜成形术。治疗成功定义为在 3 个月随访时鼓膜完整。术前和术后第 3 个月记录骨导 (BC) 和气导 (AC) 在 0.5、1、2、3 和 4 kHz 的阈值。30 例患者的穿孔大小范围为 13 例患者 (43%) 为 7mm,8 例患者 (27%) 为 6mm,9 例患者 (30%) 为 5mm。30 例患者中有 27 例患者采用新技术成功封闭了鼓膜穿孔,成功率为 90%。5mm 和 6mm 大小穿孔组的气骨导间隙 (dB) 平均值在术前和术后相似 (p = 0.09 和 p = 0.49)。然而,在 7mm 大小穿孔组中,术前气骨导间隙 (dB) 平均值高于术后 (p = 0.004)。所有患者的气骨导间隙 (dB) 平均值在术前高于术后 (p = 0.001)。总之,采用该技术的 FGM 可能可作为封闭大于 5mm 的鼓膜穿孔的替代方法。

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