Jyothi A C, Shrikrishna B H, Kulkarni N H, Kumar Ajay
Department of ENT and Head-Neck Surgery, Navodaya Medical College Hospital and Research Centre, Mantralayam Road, Raichur, Karnataka 584103 India.
Indian J Otolaryngol Head Neck Surg. 2017 Sep;69(3):357-362. doi: 10.1007/s12070-017-1147-9. Epub 2017 Jun 27.
Myringoplasty is one of the commonest operations performed on the middle ear. Our aim was to compare the results of endoscopic permeatal myringoplasty with that of conventional myringoplasty by post aural approach using operating microscope. A total of 120 patients having central perforation of tympanic membrane were randomly divided into two equal groups of 60 patients each. In the first group, endoscope was used and in the second group microscope was used to do myringoplasty. Temporalis fascia was used as a graft material. The patients were kept in follow-up for 1 year. The pre-operative and post-operative audiograms, post-operative pain, graft uptake and time taken for surgery were compared in both the groups. The graft uptake rate was 91.67% in the endoscopic group, whereas it was 93.3% in the microscopic group. Post-operative pain was significantly less in the endoscopic group as compared with microscopic group and not much difference was found in the gain in A-B gap in either group. The mean ABG gain was 16.16 dB (SD = 4.68) in endoscopic group and 19.54 dB (SD = 3.45) in microscopic group. On applying the Mann-Whitney test, this finding was statistically significant ( value = 0.0001). In our study success rate was equal between endoscopic and microscopic technique. In terms of morbidity and postoperative recovery endoscope produced better results. Endoscopic tympanoplasty can be a good alternative of microscopic tympanoplasty.
鼓膜成形术是中耳最常见的手术之一。我们的目的是通过使用手术显微镜经耳后入路，比较内镜下经耳道鼓膜成形术与传统鼓膜成形术的效果。总共120例鼓膜中央穿孔患者被随机分为两组，每组60例。第一组使用内镜，第二组使用显微镜进行鼓膜成形术。颞肌筋膜用作移植材料。对患者进行了1年的随访。比较了两组患者术前和术后的听力图、术后疼痛、移植物摄取情况以及手术所需时间。内镜组的移植物摄取率为91.67%，而显微镜组为93.3%。与显微镜组相比，内镜组术后疼痛明显减轻，两组在A-B间隙增益方面差异不大。内镜组的平均ABG增益为16.16dB（标准差=4.68），显微镜组为19.54dB（标准差=3.45）。应用曼-惠特尼检验，这一发现具有统计学意义（P值=0.0001）。在我们的研究中，内镜技术和显微镜技术的成功率相当。在内镜技术在发病率和术后恢复方面产生了更好的效果。内镜下鼓膜成形术可以是显微镜下鼓膜成形术的一个很好的替代方法。
