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蝶形软骨鼓室成形术的长期效果:治疗中小型穿孔的极佳方法。

Butterfly Cartilage Tympanoplasty Long-term Results: Excellent Treatment Method in Small and Medium Sized Perforations.

作者信息

Kaya Isa, Benzer Murat, Uslu Mustafa, Bilgen Cem, Kirazli Tayfun

机构信息

Department of Otorhinolaryngology, Ege University School of Medicine, Izmir, Turkey.

出版信息

Clin Exp Otorhinolaryngol. 2018 Mar;11(1):23-29. doi: 10.21053/ceo.2017.00549. Epub 2017 Aug 12.

Abstract

OBJECTIVES

The aim of this study was to evaluate and report the long-term results of the butterfly cartilage tympanoplasty. Short-term and long-term hearing outcomes were compared according to age and perforation location as well.

METHODS

Ninety-three patients who were diagnosed with noncomplicated chronic otitis media and underwent microscopic transcanal butterfly cartilage tympanoplasty due to anterior, posterior, and central tympanic membrane perforation were included. Age, gender, follow-up time, pre- and postoperative pure tone audiometry thresholds (both air and bone conduction), pre- and postoperative air-bone gaps (ABGs), if any residual perforation was noted.

RESULTS

At the end of the follow-up period, successful closure occurred in 88 of 93 patients and success rate is 94.6%. In all patients, including those with residual perforations, the mean preoperative bone conduction threshold was 15.9 dB (range, 5 to 50 dB) among all groups whereas mean air conduction threshold was 36.4±15.1 dB (range, 10 to 90 dB) preoperatively and 28.8±14.3 dB in 6th month follow-up and 24.9±14.1 dB 24th month follow-up. Preoperative mean ABG was 22.1±7.1 dB (range, 5 to 40 dB) whereas 13.3±5.9 dB 6 months after surgery and 11.9±5.5 dB 24 months after surgery. There was a significant difference between pre- and postoperative ABG in both 6th and 24th month follow-up (<0.05). Furthermore, preoperative mean air conduction differed significantly from postoperative 6th and 24th month follow-up mean air conduction thresholds (<0.05).

CONCLUSION

We suggested that butterfly cartilage tympanoplasty can be safely performed in small, moderate, and even large perforations, as the hearing outcomes and successful closure rate are similar to those of other surgical methods. Moreover, it can be performed under local anaesthesia and it has low complication rates.

摘要

目的

本研究旨在评估并报告蝶形软骨鼓室成形术的长期效果。还根据年龄和穿孔位置比较了短期和长期听力结果。

方法

纳入93例被诊断为非复杂性慢性中耳炎且因鼓膜前、后及中央穿孔而接受显微镜下经耳道蝶形软骨鼓室成形术的患者。记录年龄、性别、随访时间、术前和术后纯音听力测定阈值(气导和骨导)、术前和术后气骨导间距(ABG),以及是否存在残余穿孔。

结果

随访期末,93例患者中有88例成功封闭穿孔,成功率为94.6%。在所有患者中,包括有残余穿孔的患者,所有组术前平均骨导阈值为15.9 dB(范围5至50 dB),术前平均气导阈值为36.4±15.1 dB(范围10至90 dB),术后6个月为28.8±14.3 dB,术后24个月为24.9±14.1 dB。术前平均ABG为22.1±7.1 dB(范围5至40 dB),术后6个月为13.3±5.9 dB,术后24个月为11.9±5.5 dB。术后6个月和24个月随访时,术前和术后ABG之间存在显著差异(<0.05)。此外,术前平均气导与术后6个月和24个月随访时的平均气导阈值存在显著差异(<0.05)。

结论

我们认为,蝶形软骨鼓室成形术可安全用于小、中甚至大穿孔,因为其听力结果和成功封闭率与其他手术方法相似。此外,该手术可在局部麻醉下进行,并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3c7/5831663/bd27b2c5429e/ceo-2017-00549f1.jpg

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