Shim Dae Bo, Kim Hyun Ji, Kim Mi Joo, Moon In Seok
Department of Otorhinolaryngology, 1Myongji Hospital , Goyang, Gyeonggi-do.
Acta Otolaryngol. 2015 May;135(5):429-34. doi: 10.3109/00016489.2014.985800. Epub 2015 Mar 5.
The three-point fix tympanoplasty procedure is a stable and effective technique - with a high degree of graft take and satisfactory hearing results - for reconstruction of most tympanic membrane (TM) perforations.
It is difficult to repair a TM perforation, including subtotal perforation, involving the anterior part of the annulus. Reperforation can occur when an underlay graft technique is used. An overlay graft technique may result in anterior blunting/lateralization. We introduce a three-point fix tympanoplasty procedure, which can provide additional support to yield a stable graft.
The study enrolled a total of 234 patients who underwent a three-point fix tympanoplasty procedure from November 2005 to June 2011. Anatomic success was defined as an intact, repaired TM, while functional success was defined as a significant decrease in the air-bone gap at the end of follow-up compared with preoperative hearing (air-bone gap). The complication rate was also analyzed.
The anatomic success rate was 93.2% (218/234 patients). The functional success rate after an average of 1 year was 73.5%. The postoperative average pure-tone air-bone gap (15.4 ± 11.4 dB) decreased successfully in comparison with the preoperative average air-bone gap (20.6 ± 12.1 dB). There were few postoperative complications (7.7%).
三点固定鼓室成形术是一种稳定且有效的技术——移植物成活率高，听力结果令人满意——用于修复大多数鼓膜穿孔。
修复包括累及鼓环前部的次全穿孔在内的鼓膜穿孔具有挑战性。采用内置法移植物技术时可能会发生再穿孔。外置法移植物技术可能会导致前部钝圆/外侧化。我们介绍一种三点固定鼓室成形术，该技术可提供额外支撑以使移植物稳定。
本研究纳入了2005年11月至2011年6月期间共234例行三点固定鼓室成形术的患者。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较术前听力（气骨导间距）显著缩小。同时分析并发症发生率。
解剖学成功率为93.2%（218/234例患者）。平均1年后的功能成功率为73.5%。术后平均纯音气骨导间距（15.4±11.4 dB）较术前平均气骨导间距（20.6±12.1 dB）成功缩小。术后并发症较少（7.7%）。
