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单纯鼓膜成形术与伴乳突根治术的鼓膜成形术治疗慢性化脓性中耳炎鼓室黏膜型的对比评估

Comparative Evaluation of Tympanoplasty with or Without Mastoidectomy in Treatment of Chronic Suppurative Otitis Media Tubotympanic Type.

作者信息

Agrawal Anjana, Bhargava Puneet

机构信息

R.D. Gardi Medical College, Ujjain, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2017 Jun;69(2):172-175. doi: 10.1007/s12070-016-1038-5. Epub 2017 Jan 11.

Abstract

To study the role of tympanoplasty alone and tympanoplasty done along with cortical mastoidectomy in CSOM in term of graft uptake, improvement of hearing and removal of disease. This is retrospective study of patient at tertiary referral centre, conducted in between October 2015 and October 2016, study was done on 40 patients of either sex in the age group 20-50 years. Tympanoplasty alone was done in 20 cases and tympanoplasty along with cortical mastoidectomy was done in rest 20 cases. Patient were reviewed post operatively on 2, 4, 8 and 16 weeks to inspect post operative graft uptake and PTA was done at fourth month to evaluate hearing improvement. Hearing improvement was compared in both the groups in tympanoplasty group was 9.41 and in tympanoplasty combined with cortical mastoidectomy was 12.05. Graft uptake was 80% in tympanoplasty group and 95% in tympanoplasty combined with cortical mastoidectomy. Recurrence of discharge was seen in 4 cases of tympanoplasty. Though tympanoplasty combined with cortical mastoidectomy is better in hearing improvement, graft uptake and clinical improvement but the difference in 2 groups is statistically insignificant. Results of tympanoplasty alone and tympanoplasty along with cortical mastoidectomy in terms of hearing gain and graft uptake were statistically insignificant.

摘要

为研究单纯鼓室成形术以及鼓室成形术联合皮质骨乳突切除术在慢性化脓性中耳炎(CSOM)患者中对移植物吸收、听力改善及疾病清除方面的作用。这是一项在三级转诊中心对患者进行的回顾性研究,研究时间为2015年10月至2016年10月,研究对象为40例年龄在20 - 50岁的患者,男女不限。其中20例患者接受单纯鼓室成形术,其余20例患者接受鼓室成形术联合皮质骨乳突切除术。术后分别在2周、4周、8周和16周对患者进行复查,以检查术后移植物吸收情况,并在术后第四个月进行纯音听阈测试(PTA)以评估听力改善情况。单纯鼓室成形术组听力改善值为9.41,鼓室成形术联合皮质骨乳突切除术组为12.05。单纯鼓室成形术组移植物吸收率为80%,鼓室成形术联合皮质骨乳突切除术组为95%。单纯鼓室成形术组有4例出现耳漏复发。虽然鼓室成形术联合皮质骨乳突切除术在听力改善、移植物吸收及临床改善方面效果更好,但两组之间的差异无统计学意义。单纯鼓室成形术与鼓室成形术联合皮质骨乳突切除术在听力增益和移植物吸收方面的结果无统计学意义。

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