Kim Hyun Ji, Kim Mi Joo, Jeon Ju Hyun, Kim Jung Min, Moon In Seok, Lee Won-Sang
*Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, and †Department of Otorhinolaryngology, Inje University College of Medicine, Go-yang, Republic of Korea.
Otol Neurotol. 2014 Sep;35(8):1458-62. doi: 10.1097/MAO.0000000000000419.
For tympanoplasty, the most common grafting materials are the temporalis fascia or perichondrium; however, both require incision of the canal skin, which carries a risk of morbidity and the need for postoperative care. Inlay butterfly cartilage tympanoplasty, by which the perforation edges are refreshed and a cartilage is inserted through the perforation without canal incision, makes the graft easy, and reduces operating and recovery time. We analyze the outcome of inlay butterfly cartilage tympanoplasty.
This study included 112 patients who underwent tympanoplasty from January 2011 to August 2012. Patients were divided into 2 groups: patients who underwent inlay butterfly cartilage tympanoplasty (Group I, n = 56) and patients who underwent conventional underlay tympanoplasty using the temporalis fascia (Group II, n = 56). Anatomic success was defined as an intact, repaired tympanic membrane, and functional success was defined as a significant decrease in the air-bone gap at the end of follow-up. Perioperative pain was analyzed using a visual analogue scale (VAS). Surgical success, functional success, perioperative pain, and operating time were evaluated and compared.
The surgical success rate was 96.4% in Group I and 91.1% in Group II (p = 0.435). The mean air-bone gap decrease was 7.9 ± 2.2 dB in Group I and 8.9 ± 3.2 dB in Group II (p = 0.426). Group I showed a lower VAS score for pain (1.5 ± 1.2) and a shorter operation time (25.6 ± 8.5 min) compared with those of Group II (4.9 ± 1.7, 48.6 ± 19.5 min, respectively) (p < 0.01).
Inlay butterfly cartilage tympanoplasty is compatible with the conventional underlay technique in both anatomic and functional success rates. Its simplicity, shorter operation time, and rapid recovery time could make it an attractive surgical option.
对于鼓室成形术,最常用的移植材料是颞肌筋膜或软骨膜;然而,这两种材料都需要切开外耳道皮肤,存在发病风险且术后需要护理。镶嵌式蝶形软骨鼓室成形术通过修整穿孔边缘并在不切开外耳道的情况下通过穿孔插入软骨,使移植操作简便,并减少了手术和恢复时间。我们分析了镶嵌式蝶形软骨鼓室成形术的效果。
本研究纳入了2011年1月至2012年8月期间接受鼓室成形术的112例患者。患者分为2组:接受镶嵌式蝶形软骨鼓室成形术的患者(I组,n = 56)和接受使用颞肌筋膜的传统夹层鼓室成形术的患者(II组,n = 56)。解剖学成功定义为鼓膜完整、修复,功能成功定义为随访结束时气骨导间距显著减小。使用视觉模拟评分法(VAS)分析围手术期疼痛情况。评估并比较手术成功率、功能成功率、围手术期疼痛和手术时间。
I组手术成功率为96.4%,II组为91.1%(p = 0.435)。I组平均气骨导间距减小7.9±2.2 dB,II组为8.9±3.2 dB(p = 0.426)。与II组相比,I组疼痛的VAS评分较低(1.5±1.2),手术时间较短(分别为25.6±8.5分钟和48.6±19.5分钟)(p < 0.01)。
镶嵌式蝶形软骨鼓室成形术在解剖学和功能成功率方面与传统夹层技术相当。其操作简单、手术时间短和恢复时间快,可能使其成为一种有吸引力的手术选择。