Park Shi-Nae, Kim Hyo-Min, Jin Kyung-Suk, Maeng Jae-Hoan, Yeo Sang-Won, Park So-Young
Department of Otorhinolaryngology-Head and Neck Surgery, The Catholic University of Korea College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
Eur Arch Otorhinolaryngol. 2015 Feb;272(2):297-301. doi: 10.1007/s00405-013-2860-y. Epub 2013 Dec 10.
The purpose of the present study is to evaluate the outcome of paper patch myringoplasty for chronic tympanic membrane (TM) perforations and to explore the predictive factors for a successful closure. A retrospective study was performed in a tertiary referral center. Data of the patients who met the inclusion criteria were analyzed: the treatment outcomes and the potential predictive factors including age, sex, the affected ear, hearing level, duration of perforation, causes, location and size of perforations, relationship between the perforation border and the malleus, status of TM surface, and the number of patch applications. Complete closure was achieved in 27 of the total 43 subjects. Among the 11 clinical and TM factors, only the perforation size remained significant as the predictor after multivariable logistic regression (p = 0.029, OR 4.4). The patients with perforation ≤ 5% of the TM showed higher closure rate (78.3%) than those with perforation >5% (45.0%). In conclusion, paper patch myringoplasty showed overall success rate of 62.8%. In patients with perforations smaller than 5% of the TM, the closure rate was 78.3%. The predictor of the treatment outcome was the perforation size. We can try paper patch myringoplasty first in patients who had dry chronic perforations smaller than 5% of the TM without middle ear disease.
本研究的目的是评估慢性鼓膜穿孔的纸片贴补鼓膜成形术的疗效，并探讨成功愈合的预测因素。在一家三级转诊中心进行了一项回顾性研究。对符合纳入标准的患者数据进行分析：治疗结果以及潜在的预测因素，包括年龄、性别、患耳、听力水平、穿孔持续时间、病因、穿孔的位置和大小、穿孔边缘与锤骨的关系、鼓膜表面状况以及贴片应用次数。43名受试者中共有27名实现了完全愈合。在11项临床和鼓膜因素中，多变量逻辑回归后只有穿孔大小作为预测因素仍具有显著性（p = 0.029，OR 4.4）。穿孔面积≤鼓膜5%的患者愈合率（78.3%）高于穿孔面积>5%的患者（45.0%）。总之，纸片贴补鼓膜成形术的总体成功率为62.8%。在穿孔面积小于鼓膜5%的患者中，愈合率为78.3%。治疗结果的预测因素是穿孔大小。对于鼓膜穿孔面积小于5%且无中耳疾病的干性慢性穿孔患者，我们可以首先尝试纸片贴补鼓膜成形术。
