Otolaryngology-Head and Neck Department, Minia University Hospital, Minia, Egypt.
JAMA Otolaryngol Head Neck Surg. 2015 Jun;141(6):532-8. doi: 10.1001/jamaoto.2015.0601.
The main objective in the treatment of chronic otitis media is to relieve drainage and to rehabilitate hearing. Various materials can be used to repair the tympanic membrane (TM) through different tympanoplasty techniques.
To assess the results of endoscopic type I tympanoplasty in pediatric patients using tragal cartilage as a grafting material.
DESIGN, SETTING, AND PARTICIPANTS: In this prospective study, we studied 80 ears in 80 pediatric patients (ages, 5-17 years) who had undergone type I tympanoplasty from January 2011 to December 2013 at a tertiary referral hospital. We classified our patients into a younger group (≤10 years; n = 40) and an older group (>10 years; n = 40). Patients were followed for up to 6 months.
Endoscopic type I tympanoplasty using split-thickness tragal cartilage.
We identified the following criteria for success: (1) healing of the TM (anatomical success) and (2) improvement in hearing by assessing the change in the air-bone gap (ABG). We also assessed the mean operation duration and the different prognostic factors.
Healing of the TM healing occurred in 34 patients (85%) in the younger group vs 36 patients (90%) in the older group. Both groups had notable improvement compared with the preoperative measurements, with no significant differences between the 2 groups. Thirty patients (75%) in the younger group had improvement in their ABG vs 32 patients (80%) in the older group, with a mean ABG of 8.0 dB and 10.5 dB in the younger and older groups, respectively. Both groups had significant functional success with no significant differences between the 2 groups. Sixty patients (75%) displayed a type A tympanogram at their 6-month postoperative audiometric testing (28 patients in the younger group vs 32 patients in the older group). There were no statistically significant differences regarding the anatomical and functional success between the patients who had previously undergone adenotonsillectomy and the other patients. The mean (SD) operation duration was 55.03 (2.50) minutes.
In pediatric patients undergoing type I tympanoplasty, the endoscopic approach using the tragal cartilage as a grafting material resulted in successful anatomical and functional outcomes that are in comparable to other techniques but with a shorter operation duration. Age of the patient, auditory tube dysfunction, and previous adenotonsillectomy were not prognostic factors for this procedure.
慢性中耳炎治疗的主要目标是缓解引流并恢复听力。各种材料可通过不同的鼓室成形术技术用于修复鼓膜（TM）。
评估使用耳屏软骨作为移植物的小儿内镜 I 型鼓室成形术的结果。
设计、设置和参与者：在这项前瞻性研究中，我们研究了 2011 年 1 月至 2013 年 12 月在一家三级转诊医院接受 I 型鼓室成形术的 80 名小儿患者（年龄 5-17 岁）的 80 只耳朵。我们将患者分为年龄较小组（≤10 岁；n=40）和年龄较大组（>10 岁；n=40）。患者随访时间长达 6 个月。
使用耳屏软骨进行内镜 I 型鼓室成形术。
我们确定了以下成功标准：（1）TM 愈合（解剖学成功）和（2）通过评估气骨导差（ABG）的变化来评估听力改善。我们还评估了平均手术时间和不同的预后因素。
在年轻组中，34 名患者（85%）的 TM 愈合，在年龄较大组中，36 名患者（90%）的 TM 愈合。两组与术前测量相比均有明显改善，两组间无显著差异。在年轻组中，30 名患者（75%）的 ABG 改善，在年龄较大组中，32 名患者（80%）的 ABG 改善，年轻组和年龄较大组的平均 ABG 分别为 8.0dB 和 10.5dB。两组均有显著的功能成功，两组间无显著差异。在术后 6 个月的听力测试中，60 名患者（75%）显示出 A 型鼓室图（年轻组 28 名患者，年龄较大组 32 名患者）。在先前接受过腺样体扁桃体切除术和其他患者之间，解剖学和功能成功方面没有统计学上的显著差异。平均（SD）手术时间为 55.03（2.50）分钟。
在接受 I 型鼓室成形术的小儿患者中，使用耳屏软骨作为移植物的内镜方法可获得成功的解剖学和功能结果，与其他技术相当，但手术时间更短。患者年龄、咽鼓管功能障碍和先前的腺样体扁桃体切除术不是该手术的预后因素。
