Yilmaz Mahmut Sinan, Guven Mehmet, Kayabasoglu Gurkan, Varli Ali Fuat
Department of Otorhinolaryngology, Sakarya University Faculty of Medicine Training and Research Hospital, Adapazari, Sakarya, Turkey,
Eur Arch Otorhinolaryngol. 2015 Mar;272(3):557-62. doi: 10.1007/s00405-013-2869-2. Epub 2013 Dec 27.
As a graft material cartilage produces an excellent anatomical result with a low risk of re-perforation. However, there is a controversy among surgeons regarding its sound conduction properties, due to the thickness and stiffness of the cartilage. The aim of this study was to evaluate results of cartilage type I tympanoplasty and to compare anatomic and audiologic results in pediatric and adult patients. Patients with chronic otitis media who underwent cartilage type I tympanoplasty were evaluated retrospectively. Patient age, gender, pre and postoperative hearing levels, surgical technique and postoperative complications were recorded. Hearing outcomes of the patients were measured with tonal audiometry by comparing the pre and postoperative hearing threshold calculated at 0.5, 1, 2, and 4 kHz. Graft success rates and hearing outcomes of the pediatric and adult patients were compared. Of the 136 patients included in the study, 58 were male and 78 were female. The average age was 25.03. Forty-five patients were ≤16-year old and 91 patients were >16-year old. Intact graft was determined in 41 of 45 pediatric patients and 85 of 91 adult patients at the last follow-up visit. The overall graft success rate was 92.6 %. The mean pre and postoperative pure-tone average was 34.8 ± 8.5 and 23.4 ± 9.1 dB in adult patients, and 30.6 ± 7.7 and 17.8 ± 7.8 dB in pediatric patients. Cartilage graft provides a quite satisfactory anatomical result and perfect stability. Hearing outcomes of cartilage tympanoplasty are also acceptable in both children and adult patients.
作为一种移植材料，软骨能产生极佳的解剖学效果，再次穿孔风险低。然而，由于软骨的厚度和硬度，外科医生们对其传音特性存在争议。本研究的目的是评估I型软骨鼓膜成形术的效果，并比较儿童和成人患者的解剖学和听力学结果。对接受I型软骨鼓膜成形术的慢性中耳炎患者进行回顾性评估。记录患者的年龄、性别、术前和术后听力水平、手术技术及术后并发症。通过比较在0.5、1、2和4千赫计算的术前和术后听力阈值，用纯音听力测定法测量患者的听力结果。比较儿童和成人患者的移植物成功率和听力结果。纳入研究的136例患者中，男性58例，女性78例。平均年龄为25.03岁。≤16岁的患者有45例，>16岁的患者有91例。在最后一次随访时，45例儿童患者中有41例移植物完整，91例成人患者中有85例移植物完整。总体移植物成功率为92.6%。成人患者术前和术后纯音平均听阈分别为34.8±8.5和23.4±9.1分贝，儿童患者分别为30.6±7.7和17.8±7.8分贝。软骨移植提供了相当令人满意的解剖学效果和完美的稳定性。软骨鼓膜成形术在儿童和成人患者中的听力结果也均可接受。
