Singh Namit Kant, Nagpure Prakash Shankarrao, Yadav Manish, Chavan Sushil
Assistant Professor, Department of E.N.T, M.M. Institute of Medical Science and Research , Ambala, Haryana, India .
Professor and Head, Department of E.N.T, M.G.I.M.S , Sevagram, Wardha, Maharashtra, India .
J Clin Diagn Res. 2016 Apr;10(4):MC01-4. doi: 10.7860/JCDR/2016/19001.7555. Epub 2016 Apr 1.
Tympanoplasty is the most common operation performed by an Otolaryngologist right from the period of residency. During the last hundred years various modifications in this surgical technique have come up because of continued efforts made by otologists all over the world to achieve the best surgical outcome.
To compare the graft take up and complications associated with the Permeatal Sandwich Tympanoplasty performed with the use of Otoendoscope and traditional Postaural Underlay technique of Tympanoplasty from 1(st) September 2014 to 30(th) August 2015.
Patients attending the ENT OPD, suffering from Chronic Suppurative Otitis Media (CSOM) were selected on the basis of type of perforation and their workup was done to assess the candidature for tympanoplasty.
A total of 100 patients were included in the study and the overall graft take was 92.3% in cases of Permeatal Sandwich technique as compared to 64.58% in the case of postaural underlay technique, with a majority of the failures in the large central perforation group rendering a p = 0.021 for patients operated for Large perforations, p = 0.036 for moderate perforations and p = 0.476 for small perforations. The overall p = 0.000649 which is highly significant. On comparing the complications there were only 2 cases in Permeatal Sandwich Technique compared to 25 cases in Postaural Underlay technique rendering a highly significant p-value 0f 0.000000348. There was a difference in hearing improvement with majority of the cases improving to the range of 16-25 dB in Permeatal Sandwich technique compared to 26-45 dB in Postaural Underlay technique.
Permeatal Sandwich technique produce much better results when compared with Postaural approach in terms of graft take up, complications and hearing improvement.
鼓室成形术是耳鼻喉科医生从住院实习阶段起就最常进行的手术。在过去的一百年里，由于世界各地耳科医生不断努力以实现最佳手术效果，这种手术技术出现了各种改进。
比较2014年9月1日至2015年8月30日期间，使用耳内镜进行的经耳道夹层鼓室成形术与传统的耳后衬里鼓室成形术的移植物吸收率及相关并发症。
根据穿孔类型选择前来耳鼻喉科门诊就诊的慢性化脓性中耳炎（CSOM）患者，并对其进行检查以评估鼓室成形术的候选资格。
该研究共纳入100例患者。经耳道夹层技术的总体移植物吸收率为92.3%，而耳后衬里技术为64.58%。在大的中央穿孔组中，大多数失败病例导致大穿孔手术患者的p值为0.021，中度穿孔患者的p值为0.036，小穿孔患者的p值为0.476。总体p值为0.000649，具有高度显著性。比较并发症时，经耳道夹层技术仅有2例，而耳后衬里技术有25例，p值为0.000000348，具有高度显著性。听力改善存在差异，经耳道夹层技术的大多数病例听力改善至16 - 25分贝范围，而耳后衬里技术为26 - 45分贝。
在移植物吸收率、并发症和听力改善方面，经耳道夹层技术与耳后入路相比产生了更好的效果。
