Mouna Bellakhdhar, Khalifa Mouna, Ghammem Monia, Limam Manel, Meherzi Abir, Kermani Wassim, Abdelkefi Mohamed
ENT Department, Farhat Hached University Hospital.
Department of family and community medicine, Faculty of medicine, University of Sousse, Sousse, Tunisia.
J Craniofac Surg. 2019 Jun;30(4):e297-e300. doi: 10.1097/SCS.0000000000005278.
Tympanoplasty is a surgical procedure aiming to reconstruct the tympanic membrane and hearing. The aim of this study was to compare anatomic and audiological results of cartilage graft with temporal fascia graft in type 1 tympanoplasty patients. We conducted a descriptive, retrospective study of medical records of patients who underwent tympanoplasty between January 2010 and December 2015 at the Department of Otolaryngology Head and Neck Surgery of Farhat Hached University Hospital. In total, we obtained 46 patients. Twenty-three patients who underwent type 1 cartilage tympanoplasty using cartilage graft were compared with 23 patients in whom temporal muscle fascia was used. In follow-up, residual perforation occurred in 1 of 23 patients (4.3%) undergoing cartilage tympanoplasty and in 2 of 23 patients undergoing fascia tympanoplasty (8.7%), which was found to be statistically non significant (P > 0.05). In both cartilage and fascia groups, when they were compared in terms of gain, no significant difference was found between groups (P = 0.271), air bone gap gain was found to be 12.9 ±9.9 decibels in cartilage group, whereas it was 10 ± 6.6 decibels in fascia group. Operation success is defined by successful anatomical and functional outcome. Among all patients, 35 (76%) were reported to have operation success. It was established that type of operation had no significant influence on success (P = 0.73). Currently, there is an increasing interest in using cartilage grafts in primary tympanoplasty. Especially, in patients with severe middle ear pathology, cartilage graft should be used routinely without risk on influencing audiological results.
鼓室成形术是一种旨在重建鼓膜和听力的外科手术。本研究的目的是比较1型鼓室成形术患者中软骨移植与颞肌筋膜移植的解剖学和听力学结果。我们对2010年1月至2015年12月在法哈特·哈谢德大学医院耳鼻咽喉头颈外科接受鼓室成形术的患者病历进行了描述性回顾性研究。我们共获得46例患者。将23例行1型软骨鼓室成形术使用软骨移植的患者与23例行颞肌筋膜移植的患者进行比较。随访中，23例行软骨鼓室成形术的患者中有1例（4.3%）出现残余穿孔，23例行筋膜鼓室成形术的患者中有2例（8.7%）出现残余穿孔，差异无统计学意义（P>0.05）。在软骨组和筋膜组中，就增益进行比较时，两组之间未发现显著差异（P=0.271），软骨组的气骨导差增益为12.9±9.9分贝，而筋膜组为10±6.6分贝。手术成功定义为解剖和功能结果成功。在所有患者中，35例（76%）报告手术成功。结果表明手术类型对成功率无显著影响（P=0.73）。目前，在一期鼓室成形术中使用软骨移植的兴趣日益增加。特别是，在中耳病变严重的患者中，应常规使用软骨移植，而不会有影响听力学结果的风险。
