外伤性鼓膜穿孔边缘内卷或翻转的识别与处理。

Identification and management of inverted or everted edges of traumatic tympanic membrane perforations.

机构信息

The Affiliated YiWu Hospital of Wenzhou Medical University, Department of Otorhinolaryngology, Yiwu, China.

Xinxiang Medical University, Department of Clinical Medicine, Xinxiang City, China.

出版信息

Braz J Otorhinolaryngol. 2019 Jan-Feb;85(1):17-23. doi: 10.1016/j.bjorl.2017.10.002. Epub 2017 Oct 28.

DOI:10.1016/j.bjorl.2017.10.002

PMID:29137879

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9442902/

Abstract

INTRODUCTION

Most of traumatic tympanic membrane perforations have inverted or everted edges, however, the effects of inverted and everted edges on the spontaneous healing of the eardrum remain controversial.

OBJECTIVE

We investigated the influence of inverted or everted edges on the spontaneous healing of traumatic tympanic membrane perforations.

METHODS

The clinical records of patients with a traumatic tympanic membrane perforations who met the study criteria were retrieved and categorized into two groups, based on whether the eardrum was inverted or everted. The features along the edge of each inverted or everted eardrum were described using 30° and 70° endoscopes.

RESULTS

In total, 196 patients (196 ears) met the inclusion criteria; of these, 148 had inverted or everted eardrums while 48 did not. Of the 148 patients with inverted or everted eardrums, the perforation edges were everted in 77 patients, inverted in 44 patients, drooping in 17 patients, and both inverted and everted in 10 patients. The perforation shape was triangular in 18.9% of patients, sector-shaped in 11.5%, kidney-shaped in 14.2%, ovoid in 20.3%, and irregularly shaped in 35.1% of patients. The difference was not significant between the with and without inverted/everted eardrum edges groups in terms of the closure rate or closure time. Similarly, the difference was not significant between the with and without edge approximation groups in terms of the closure rate or closure time at the end of the 12-month follow-up period.

CONCLUSION

This study suggests that endoscopic inspection can clearly identify inverted/everted eardrum edges using 30° and 70° endoscopes. The edge is glossy in inverted/everted eardrums, whereas the edge is rough and irregular in non-inverted/everted cases. The inverted/everted eardrums gradually became necrotic, but this did not affect the healing process. Additionally, edge approximation did not improve the healing outcome of traumatic tympanic membrane perforations.

摘要

简介

大多数外伤性鼓膜穿孔的边缘为内翻或外翻，但鼓膜内、外翻边缘对鼓膜自发性愈合的影响仍存在争议。

目的

我们研究了内、外翻边缘对外伤性鼓膜穿孔自发性愈合的影响。

方法

检索并根据鼓膜是否内、外翻将符合研究标准的外伤性鼓膜穿孔患者的临床记录分为两组。使用 30°和 70°内镜描述每一个内、外翻鼓膜边缘的特征。

结果

共有 196 例（196 耳）符合纳入标准，其中 148 例鼓膜内、外翻，48 例鼓膜无内、外翻。148 例鼓膜内、外翻患者中，鼓膜边缘向外翻者 77 例，向内翻者 44 例，下垂者 17 例，内、外翻并存者 10 例。穿孔形状为三角形者占 18.9%，扇形者占 11.5%，半月形者占 14.2%，椭圆形者占 20.3%，不规则形者占 35.1%。鼓膜内、外翻组和无内、外翻组在愈合率和愈合时间上差异无统计学意义。同样，在 12 个月随访期末，鼓膜边缘接近组和无边缘接近组在愈合率和愈合时间上差异也无统计学意义。