Tseng Chih-Chieh, Lai Ming-Tang, Wu Chia-Che, Yuan Sheng-Po, Ding Yi-Fang
Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taiwan; Department of Otolaryngology, PoJen General Hospital, Taipei, Taiwan; Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taiwan.
Department of Otolaryngology, Wan Fang Medical Center, Taipei Medical University, Taiwan.
Auris Nasus Larynx. 2017 Dec;44(6):672-677. doi: 10.1016/j.anl.2016.12.007. Epub 2017 Jan 22.
The tympanomeatal flap elevation technique has been used in tympanoplasty for decades; however, this procedure has disadvantages. In recent years, endoscopic transcanal myringoplasty (ETM) has been increasingly practiced and has yielded positive results.This study compares the efficacy of ETM and endoscopic type I tympanoplasty (ETT) in repairing medium-sized perforations of the tympanic membrane.
This retrospective medical record review included patients undergoing surgery for medium-sized perforations of the tympanic membrane from January 1, 2013 to August 1, 2015. We divided our patients into 2 groups: the ETM group and ETT group. The main outcome measure was comparison of the graft take rates and hearing results between ETM and ETT.
A total of 113 patients were enrolled in this study; of these patients, 64 underwent ETM and 49 received ETT. The overall graft take rates and improvement of air-bone gaps were comparable between the groups. However, the patients in the ETM group had shorter operative times and fewer follow-up visits over 3 months than those in the ETT group did.
We recommend that ETM (instead of ETT) be used for repairing medium-sized perforations of the tympanic membrane.
鼓室-外耳道皮瓣掀起技术已在鼓室成形术中应用数十年；然而，该手术存在缺点。近年来，内镜经耳道鼓膜成形术（ETM）的应用越来越广泛，并取得了积极成果。本研究比较了ETM和内镜I型鼓室成形术（ETT）修复鼓膜中等大小穿孔的疗效。
这项回顾性病历审查纳入了2013年1月1日至2015年8月1日期间因鼓膜中等大小穿孔接受手术的患者。我们将患者分为两组：ETM组和ETT组。主要观察指标是比较ETM和ETT之间的移植物成活率及听力结果。
本研究共纳入113例患者；其中，64例行ETM，49例行ETT。两组的总体移植物成活率和气骨导差改善情况相当。然而，ETM组患者的手术时间比ETT组短，且在3个月内的随访次数也比ETT组少。
我们建议使用ETM（而非ETT）修复鼓膜中等大小穿孔。
