内镜与显微镜下鼓室成形术的回顾性对比研究。
A retrospective comparative study of endoscopic and microscopic Tympanoplasty.
机构信息
Department of Otorhinolaryngology, Cathay General Hospital, 280 Ren-Ai Rd. Sec. 4, Taipei, Taiwan.
Department of Otolaryngology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China.
出版信息
J Otolaryngol Head Neck Surg. 2018 Jul 4;47(1):44. doi: 10.1186/s40463-018-0289-4.
BACKGROUND
This study compares endoscopic and microscopic tympanoplasty for the treatment of chronic otitis media (COM) without cholesteatoma.
METHODS
This retrospective study included 153 ears (139 patients) treated surgically (endoscopic or microscopic tympanoplasty) for COM in the absence of cholesteatoma at our hospital between January 2008 and October 2015. The adoption of transcanal endoscopic ear surgery (TEES) or microscopic ear surgery (MES) was divided temporally (before and since 2014). Comparisons between these groups focused on the following: (I) surgical outcomes, including successful tympanic membrane healing and post-operative complications; (II) restoration of hearing; and (III) consumption of medical resources, including the duration of surgery and anesthesia. All patients had a follow-up period of at least 3 months after surgery.
RESULTS
No statistically significant differences were observed between the two groups regarding surgical outcome or hearing restoration. TEES resulted in the successful healing of 96.2% of ear drums, whereas MES led to successful healing in 92% (p = 0.2826) of cases. The average hearing gains following surgery were 10.27 ± 6.4 and 12.43 ± 7.46 dB in TEES and MES, respectively. The consumption of medical resources in the TEES group was lower than that of the MES group (TEES versus MES) regarding the average operating time (87.8 ± 19.01 min (mins) versus 110.2 ± 17.0 (mins) (p < 0.0001)) and the mean duration of anesthesia ((for general anesthesia patients) (122.1 ± 21.25 mins versus 145.8 ± 16.88 mins) (p ≤ 0.0001)).
CONCLUSIONS
The results indicate that TEES can achieve surgical outcomes and hearing restoration comparable to those of MES. In addition, TEES appears to be associated with shorter surgical and anesthesia time, which makes it an ideal alternative for the management of COM without cholesteatoma.
TRIAL REGISTRATION
This study was approved by the Institutional Review Board of the Cathay General Hospital. (CGHIRB No: CGH-P105012 ).
背景
本研究比较了内镜和显微镜下鼓室成形术治疗无胆脂瘤的慢性中耳炎（COM）。
方法
本回顾性研究纳入了 2008 年 1 月至 2015 年 10 月期间我院收治的 139 例（153 耳）无胆脂瘤性 COM 患者，均接受手术治疗（内镜或显微镜下鼓室成形术）。采用经耳道内镜耳外科手术（TEES）或显微镜耳外科手术（MES）治疗。比较两组之间的差异主要包括：（I）手术结果，包括鼓膜愈合和术后并发症；（II）听力恢复；（III）医疗资源消耗，包括手术和麻醉时间。所有患者术后随访时间均至少 3 个月。
结果
两组在手术结果或听力恢复方面无统计学差异。TEES 组鼓膜愈合成功率为 96.2%，MES 组为 92%（p=0.2826）。TEES 组和 MES 组术后平均听力增益分别为 10.27±6.4dB 和 12.43±7.46dB。TEES 组在手术时间（87.8±19.01min 与 110.2±17.0min（p<0.0001））和麻醉时间（全麻患者）（122.1±21.25min 与 145.8±16.88min（p≤0.0001））方面均低于 MES 组。
结论
结果表明 TEES 可达到与 MES 相当的手术结果和听力恢复。此外，TEES 似乎与较短的手术和麻醉时间相关，使其成为无胆脂瘤性 COM 管理的理想选择。
试验注册
本研究得到国泰综合医院机构审查委员会的批准（CGHIRB 编号：CGH-P105012）。
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