Bartel R, Levorato M, Adroher M, Cardelus S, Diaz A, Lacima J, Vazquez C, Veneri A, Wienberg P, Claveria M A, Haag O H
Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain.
Otolaryngology Department, Barcelona Children's Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Catalonia, Spain.
Int J Pediatr Otorhinolaryngol. 2019 Jun;121:120-122. doi: 10.1016/j.ijporl.2019.03.012. Epub 2019 Mar 12.
Endoscopic type 1 tympanoplasty is every day gaining numerous adepts for tympanic membrane repair. Due to the value of reducing postauricular approaches, decreasing postoperative morbidity and hospitalization time. The objective of this study is to present surgical results of endoscopic type 1 tympanoplasty in the pediatric population using fascia temporalis or cartilage butterfly graft.
Prospective study regarding the pediatric population, mean age of 10.7 years old. Patients diagnosed with chronic otitis media without cholesteatoma and intact ossicular chain. Tympanic membrane reconstruction using inlay cartilage butterfly graft or underlay fascia temporalis graft according to surgical needs. Audiograms were evaluated preoperatively and 6 months after surgery. No postauricular approaches were performed.
A total of 54 ears were operated, 25 utilizing underlay fascia temporalis graft and 29 using inlay cartilage butterfly graft. Six months following surgery, dry and closed tympanic membranes were obtained in 54 cases (92.6%). Preoperative and postoperative air conduction (AC) thresholds, bone conduction (BC) thresholds and air-bone gaps (ABG) were assessed. Preoperative AC of 24.6 dB, BC of 8.9 dB and an ABG of 15.5 dB. Postoperative AC of 16.3 dB, BC of 8.9 and an ABG of 6.9 dB. A postoperative ABG reduction of 8.5 dB was reached.
Transcanal endoscopic type 1 tympanoplasty can be achieved in every pediatric patient with chronic otitis media without cholesteatoma, and, is a safe and efficient procedure.
内镜下Ⅰ型鼓室成形术在鼓膜修复方面日益受到众多从业者的青睐。因其具有减少耳后入路、降低术后发病率和缩短住院时间的优点。本研究的目的是展示使用颞肌筋膜或软骨蝶形移植物进行内镜下Ⅰ型鼓室成形术在儿科患者中的手术效果。
对儿科患者进行前瞻性研究，平均年龄为10.7岁。患者诊断为无胆脂瘤的慢性中耳炎且听骨链完整。根据手术需要，使用镶嵌软骨蝶形移植物或颞肌筋膜下置移植物进行鼓膜重建。术前及术后6个月评估听力图。未进行耳后入路手术。
共对54只耳进行了手术，其中25只使用颞肌筋膜下置移植物，29只使用镶嵌软骨蝶形移植物。术后6个月，54例（92.6%）获得了干燥且闭合的鼓膜。评估了术前及术后的气导（AC）阈值、骨导（BC）阈值和气骨导差（ABG）。术前AC为24.6dB，BC为8.9dB，ABG为15.5dB。术后AC为16.3dB，BC为8.9dB，ABG为6.9dB。术后ABG降低了8.5dB。
对于每一位无胆脂瘤的慢性中耳炎儿科患者，经耳道内镜下Ⅰ型鼓室成形术均可实现，且是一种安全有效的手术方法。
