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软骨栅栏和颞肌筋膜技术行Ⅰ型鼓室成形术:一项比较研究

Type 1 Tympanoplasty by Cartilage Palisade and Temporalis Fascia Technique: A Comparison.

作者信息

Arora Nikhil, Passey J C, Agarwal A K, Bansal R

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Maulana Azad Medical College, D-55 Arya Nagar Apartment, I.P Extension, Patparganj, New Delhi, 110092 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2017 Sep;69(3):380-384. doi: 10.1007/s12070-017-1137-y. Epub 2017 Apr 29.

Abstract

(1) To compare graft take up of type-1 tympanoplasty with cartilage palisade technique with those of type-1 tympanoplasty using autotemporalis fascia. (2) To compare hearing results of type 1 tympanoplasty with cartilage palisade technique with those of type-1 tympanoplasty using autotemporalis fascia. A prospective clinical study. It consisted of 60 patients divided into two groups of 30 patients each. After randomization 30 patients underwent type 1 tympanoplasty using cartilage palisade technique and 30 underwent type 1 tympanoplasty using autotemporalis fascia. In follow up, pure tone audiogram were carried out at 2nd, 4th and 6th month. Clinical assessment was done at 2nd 4th and 6th month. The graft uptake rate between the group 1 and group 2 are 93.33 and 90% respectively. As value was greater than 0.05 so statistically there is no significant difference between the two group. The post operative air bone gap of the two groups were compared using student test. The pre op mean of group 1 was 32.5 db and pre op mean of group 2 was 30.66 db. The post op mean of group 1 was 21.33, with standard deviation of 3.6984 and standard error of 0.67523. The post op mean of group 2 was 21.09 with standard deviation of 3.29 and standard error of 0.58261. t value was 0.1357. Analysis was done using student test and value was found to be greater than 0.05. value is greater than 0.05 which shows that there is no statistical difference between the two groups. This study establishes the fact that hearing results after performing type 1 tympanoplasty by autotemporalis fascia when compared with type 1 tympanoplasty performed by cartilage palisade technique showed similar hearing gain and post operatively graft take up rate was also similar in two groups. The disadvantage of reducing the mechanical vibration of the tympanic membrane was overcome by the palisade reconstruction of the tympanic membrane. This study definitely emphasizes upon usage of new grafting materials in reconstruction of tympanic membrane, with similar, if not better functional results, without compromising the acoustic transfer characteristics.

摘要

(1) 比较采用软骨栅栏技术的Ⅰ型鼓室成形术与使用自体颞肌筋膜的Ⅰ型鼓室成形术的移植物吸收率。(2) 比较采用软骨栅栏技术的Ⅰ型鼓室成形术与使用自体颞肌筋膜的Ⅰ型鼓室成形术的听力结果。一项前瞻性临床研究。该研究包含60例患者,分为两组,每组30例。随机分组后,30例患者接受采用软骨栅栏技术的Ⅰ型鼓室成形术,30例接受采用自体颞肌筋膜的Ⅰ型鼓室成形术。在随访过程中,于第2、4和6个月进行纯音听力图检查。在第2、4和6个月进行临床评估。第1组和第2组的移植物吸收率分别为93.33%和90%。由于P值大于0.05,所以两组在统计学上无显著差异。使用学生t检验比较两组的术后气骨导间距。第1组术前平均值为32.5分贝,第2组术前平均值为30.66分贝。第1组术后平均值为21.33,标准差为3.6984,标准误为0.67523。第2组术后平均值为21.09,标准差为3.29,标准误为0.58261。t值为0.1357。采用学生t检验进行分析,发现P值大于0.05。P值大于0.05表明两组之间无统计学差异。本研究证实了这样一个事实,即与采用软骨栅栏技术的Ⅰ型鼓室成形术相比,采用自体颞肌筋膜的Ⅰ型鼓室成形术后的听力改善相似,且两组术后移植物吸收率也相似。鼓膜的栅栏状重建克服了减少鼓膜机械振动的缺点。本研究明确强调在鼓膜重建中使用新型移植物材料,即使功能结果不更好也相似,且不损害声学传递特性。

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