Knutsson Johan, Kahlin Annika, von Unge Magnus
a Department of Otorhinolaryngology , Västerås Central Hospital , Västerås , Sweden.
b Centre for Clinical Research , Uppsala University, County Hospital , Västerås , Sweden.
Acta Otolaryngol. 2017 Sep;137(9):940-944. doi: 10.1080/00016489.2017.1326063. Epub 2017 May 24.
Results of fat graft myringoplasty are often reported with only short-term follow-up. Audiological results are less commonly reported, as well as long-term follow-up results.
One hundred consecutive patients scheduled for fat graft myringoplasty were included in a prospective cohort study. Clinical and audiological outcomes were assessed at six weeks and one year postoperatively.
Perforation sizes ranged from 0.5 to 4 mm. The six-week follow-up showed a total perforation closure rate of 72.9% with a statistically significant (p = .03) higher rate for the pediatric age group (83.0%). 64.4% of all patients were healed at one-year follow-up. Statistical analyses for background factors did not reveal any significant difference in healing rates with regard to patient sex or location or cause of the perforation. The mean preoperative air-conduction (AC) threshold was 25 dB with an air-bone gap of 12 dB. At the one-year follow-up the mean air conduction threshold for healed ears was improved to 16.6 dB, still 54.2% of them had a type B tympanogram.
Children had a higher perforation closure rate at six-week follow-up than adult patients. Recurrent tympanic membrane perforations were common after initially successful fat graft myringoplasties. Long-term hearing was improved after successful fat graft myringoplasty, resulting in a mean AC threshold of 16.6 dB.
脂肪移植鼓膜成形术的结果报告通常仅涉及短期随访。听力结果的报告较少,长期随访结果亦如此。
一项前瞻性队列研究纳入了连续100例行脂肪移植鼓膜成形术的患者。在术后六周和一年时评估临床和听力结果。
穿孔大小范围为0.5至4毫米。六周随访显示总穿孔闭合率为72.9%,其中儿童年龄组的闭合率显著更高(83.0%,p = 0.03)。在一年随访时,所有患者中有64.4%愈合。对背景因素的统计分析未发现患者性别、穿孔位置或穿孔原因在愈合率方面存在任何显著差异。术前平均气导(AC)阈值为25分贝,气骨导差为12分贝。在一年随访时,愈合耳的平均气导阈值改善至16.6分贝,但其中仍有54.2%的患者鼓室图为B型。
在六周随访时,儿童的穿孔闭合率高于成年患者。在最初成功的脂肪移植鼓膜成形术后,复发性鼓膜穿孔很常见。成功的脂肪移植鼓膜成形术后长期听力得到改善,平均AC阈值为16.6分贝。