“U”形皮瓣技术与传统鼓室鼓膜瓣技术治疗前位及部分鼓膜穿孔的移植物摄取结果及听力结果比较

Outcome of Graft Uptake and Hearing Results between 'U' Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation.

作者信息

Dhungana Sundar, Rayamajhi Pabina, Shrivastav Rakesh Prakash

机构信息

Department of ENT- Head and Neck Surgery, Nepal APF Hospital, Kathmandu, Nepal.

Ganesh Man Singh Memorial Academy of ENT-Head and Neck Studies, MMC, Institute of Medicine (IOM), Kathmandu, Nepal.

出版信息

J Nepal Health Res Counc. 2018 Oct 30;16(3):297-301.

PMID:30455489

Abstract

BACKGROUND

Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between 'U' flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.

METHODS

Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sized anterior and subtotal perforation of tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in 'U' flap group and thirty two cases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.

RESULTS

Graft uptake rate was 90.3%(28/31) in'U' flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in 'U' flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).

CONCLUSIONS

The graft uptake rate and hearing results of 'U' flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group.

摘要

背景

与传统的夹层鼓膜成形术相比，针对鼓膜前部和大部分穿孔进行鼓膜成形术需要专业技能和实践经验。本研究的目的是比较“U”形皮瓣法与传统鼓室鼓膜瓣技术在鼓膜前部和大部分穿孔修复中移植物的吸收率及术后听力结果。

方法

采用抽签法将63例年龄15岁及以上、患有慢性中耳黏膜型炎症且鼓膜有任何大小前部和大部分穿孔的患者随机分配接受鼓膜成形术。“U”形皮瓣组31例，传统鼓室鼓膜瓣组32例。六周后评估移植物吸收率和听力结果，并在组内和组间进行结果比较。

结果

“U”形皮瓣组移植物吸收率为90.3%（28/31），传统鼓室鼓膜瓣组为87.5%（28/32），两组间差异无统计学意义（p = 0.772）。“U”形皮瓣组术前和术后平均气骨导差分别为23.63dB±7.77dB；13.26dB±5.50dB，传统鼓室鼓膜瓣组分别为20.88±9.88dB，9.42dB±6.70dB。两组听力结果差异无统计学意义（p = 0.504）。