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黏膜型慢性中耳炎干湿耳鼓膜成形术的研究

Study of Myringoplasty in Wet and Dry Ears in Mucosal Type of Chronic Otitis Media.

作者信息

Santosh U P, Prashanth K B, Rao Ms Sudhakar

机构信息

Professor, Department of ENT, J.J.M. Medical College , Davangere, Karnataka, India .

Postgraduate Student, Department of ENT, J.J.M. Medical College , Davangere, Karnataka, India .

出版信息

J Clin Diagn Res. 2016 Sep;10(9):MC01-MC03. doi: 10.7860/JCDR/2016/17589.8527. Epub 2016 Sep 1.

Abstract

INTRODUCTION

Chronic otitis media is the most common cause of hearing impairment in the developing countries. Hearing loss can have serious effects on day to day life. Ear discharge in chronic otitis media may continue for months to years with increasing hearing impairment and also life threatening infective complications, which is more common in active and also in inactive disease form as well. Myringoplasty is an operative procedure to close the perforation in tympanic membrane.

AIM

To compare the success rate of graft uptake in dry and wet ears and to compare the postoperative hearing improvement in dry and wet ear following myringoplasty.

MATERIALS AND METHODS

The comparative study was carried out on total 30 patients with chronic otitis media with central perforation. Of these 15 patients belong to dry ear group and 15 patients with wet ear group. These selected patients on simple random basis were subjected to clinical, audiological, radiological and laboratory investigations and one day before operation, patients were admitted to the hospital and written informed consent was taken in all cases. All patients underwent underlay technique myringoplasty. Postoperatively all patients were evaluated for graft uptake and hearing improvement by pure tone audiometry at 3 month follow-up.

RESULTS

In our study, the successful graft uptake was seen in 80% in dry ear and 73.3% in wet ear, statistically p-value (χ=1.24) is (p>0.05) which is insignificant. Postoperatively hearing gain was (0-5 dB) in 3 patients (20%) with dry ear and 2 patients (13.5%) with wet ear; (6-10 dB), in 4 patients (26.6%) with dry ear and 6 patients (40%) with wet ear; more than 10 dB in 5 patients (33.3%) with dry ear and 3 patients (20%) with wet ear, statistically p-value is χ=1.24 (p >0.05) which is not significant.

CONCLUSION

In this study the success rate of graft uptake and hearing improvement is found almost equal in dry and wet ear by using underlay technique of myringoplasty, also found statistically insignificant.

摘要

引言

慢性中耳炎是发展中国家听力障碍最常见的病因。听力损失会对日常生活产生严重影响。慢性中耳炎的耳漏可能持续数月至数年,同时听力损害加重,还会出现危及生命的感染性并发症,这在活动期和静止期疾病形式中都较为常见。鼓膜成形术是一种闭合鼓膜穿孔的手术方法。

目的

比较干耳和湿耳中移植物吸收的成功率,并比较鼓膜成形术后干耳和湿耳的听力改善情况。

材料与方法

对30例慢性中耳炎伴中央穿孔患者进行了对比研究。其中15例患者属于干耳组,15例患者属于湿耳组。这些入选患者通过简单随机抽样,接受了临床、听力学、放射学和实验室检查,术前一天患者入院,所有病例均获得书面知情同意。所有患者均接受了内植法鼓膜成形术。术后3个月随访时,通过纯音听力测定对所有患者的移植物吸收情况和听力改善情况进行评估。

结果

在我们的研究中,干耳组移植物成功吸收的比例为80%,湿耳组为73.3%,统计学p值(χ=1.24)(p>0.05),无显著差异。术后,干耳组3例患者(20%)听力增益为(0 - 5 dB),湿耳组2例患者(13.5%);干耳组4例患者(26.6%)听力增益为(6 - 10 dB),湿耳组6例患者(40%);干耳组5例患者(33.3%)听力增益超过10 dB,湿耳组3例患者(20%),统计学p值为χ=1.24(p>0.05),无显著差异。

结论

在本研究中,采用内植法鼓膜成形术时,干耳和湿耳的移植物吸收成功率及听力改善情况几乎相等,统计学上也无显著差异。

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