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小儿经耳道内镜1型鼓室成形术应使用哪种移植物?一项对比临床研究。

Which graft should be used for the pediatric transcanal endoscopic type 1 tympanoplasty? A comparative clinical study.

作者信息

Sen Alper, Özdamar Kadir

机构信息

Harran University, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Şanlıurfa, Turkey.

Private Sanmed Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Şanlıurfa, Turkey.

出版信息

Int J Pediatr Otorhinolaryngol. 2019 Jun;121:76-80. doi: 10.1016/j.ijporl.2019.02.046. Epub 2019 Mar 1.

DOI:10.1016/j.ijporl.2019.02.046
PMID:30877979
Abstract

OBJECTIVES

To compare the functional and anatomical success rates of the fascial versus perichondrial grafts in pediatric endoscopic type 1 tympanoplasties.

METHODS

This retrospective clinical study was conducted on 40 pediatric patients (23 females and 17 males; mean age: 10.0 ± 1.7 years; the age range: 6-13) who were operated with a transcanal endoscopic type 1 tympanoplasty. The study participants were assigned to two groups by graft types. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane.

RESULTS

There were not any statistically significant differences between the groups in terms of the distribution of age, gender, the operation sites, the duration of the operation, MERI scores or the size of the perforation (all p values > 0.05). The graft retention success rates were 94.7% and 90.5% in Group A and Group B, respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.609). The functional (audiological) success rate was statistically higher in Group B compared to Group A (p = 0.044).

CONCLUSION

Perichondrium and fascia grafts were found out to be acceptable for use in pediatric endoscopic tympanoplasties. The functional success rates were higher in the fascia group. We also recommended the fascia as a graft in pediatric transcanal endoscopic type 1 tympanoplasties.

摘要

目的

比较小儿内镜下Ⅰ型鼓室成形术中使用筋膜移植物与软骨膜移植物的功能成功率和解剖成功率。

方法

对40例接受经耳道内镜下Ⅰ型鼓室成形术的小儿患者(23例女性,17例男性;平均年龄:10.0±1.7岁;年龄范围:6 - 13岁)进行了这项回顾性临床研究。研究参与者根据移植物类型分为两组。患者被分配到耳屏软骨膜组(A组)或颞肌筋膜组(B组)。根据术前和术后的气骨导差以及鼓膜状况对两组进行比较。

结果

两组在年龄、性别、手术部位、手术持续时间、梅尼埃病相关指数(MERI)评分或穿孔大小的分布方面均无统计学显著差异(所有p值>0.05)。A组和B组的移植物保留成功率分别为94.7%和90.5%。两组在移植物保留成功率方面无统计学显著差异(p = 0.609)。B组的功能(听力学)成功率在统计学上高于A组(p = 0.044)。

结论

发现软骨膜和筋膜移植物可用于小儿内镜下鼓室成形术。筋膜组的功能成功率更高。我们还推荐在小儿经耳道内镜下Ⅰ型鼓室成形术中使用筋膜作为移植物。

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