Zhang J, Wang Z Y, Yang Q, Yang H D, Zhao Y, Yu Y J, Chen Y, Wang W, Zhang W
Department of Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
Department of Otorhinolaryngology Head and Neck Surgery, Nineth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Apr 7;54(4):245-250. doi: 10.3760/cma.j.issn.1673-0860.2019.04.002.
To analyze the therapeutic effect of endoscopic myringoplasty. A retrospective analysis of 523 patients with chronic otitis media who underwent endoscopic myringoplasty between June 2016 and June 2017 in eight tertiary hospitals in China. Among all the patients, 256 were male and 267 were female, aged from 18 to 68 years old. The grafts used to repair the tympanic membrane were all tragus cartilage-perichondrium complex. All patients were followed up at 1 month, 3 months, 6 months, 9 months, and 12 months after surgery, at least 3 months. The closure rate of tympanic membrane perforation by different factors, the hearing results, and the incidence of postoperative complications were analyzed. SPSS 21.0 software was used to analyze the data. Three months after operation, the closure rates of anterior, inferior, posterior and subtotal perforation were 92.4% (109/118), 94.9% (93/98), 95.6% (129/135), and 89.0% (153/172) respectively, the difference was not statistically significant (χ(2)=5.779, 0.123). The closure rates of small, medium and large perforations were 100.0% (82/82), 93.7% (178/190) and 89.2% (224/251) respectively. The difference was statistically significant (χ(2)=10.927, 0.004). The closure rates of dry ear and wet ear tympanic membrane perforation were 93.1% (392/421), 90.2% (92/102), the difference was not statistically significant (χ(2)=1.011, 0.915). The preoperative pure tone audiometry(PTA) was (38.4±5.3) dBHL, while, the 3-month postoperative PTA was (25.1±5.7) dBHL. The difference was statistically significant (39.079, 0.001). The preoperative air bone gap (ABG) was (22.4±4.3) dB, while 3 months postoperative ABG was (9.1±3.8) dB. The difference was statistically significant (53.004, 0.001). Of all 523 patients, 14 (2.7%) had middle ear infection, 8 (1.5%) had dislocated tympanic membrane, 12 (2.3%) had parageusia, 35 (6.7%) had tinnitus, 28 (5.4%) had hearing loss, 26 (5.0%) had vertigo,33 (6.3%) had reperforation, 2 (0.4%) had secondary cholesteatoma, and none had facioplegia. Endoscopic myringoplasty is a safe and effective surgical method with good postoperative outcome.
分析内镜下鼓膜成形术的治疗效果。回顾性分析2016年6月至2017年6月在中国8家三级医院接受内镜下鼓膜成形术的523例慢性中耳炎患者。所有患者中，男性256例，女性267例，年龄18至68岁。用于修复鼓膜的移植物均为耳屏软骨-软骨膜复合体。所有患者在术后1个月、3个月、6个月、9个月和12个月进行随访，随访时间至少3个月。分析不同因素导致的鼓膜穿孔闭合率、听力结果及术后并发症发生率。采用SPSS 21.0软件进行数据分析。术后3个月，前位、下位、后位及次全穿孔的闭合率分别为92.4%（109/118）、94.9%（93/98）、95.6%（129/135）和89.0%（153/172），差异无统计学意义（χ(2)=5.779，P=0.123）。小、中、大穿孔的闭合率分别为100.0%（82/82）、93.7%（178/190）和89.2%（224/251），差异有统计学意义（χ(2)=10.927，P=0.004）。干性和湿性鼓膜穿孔的闭合率分别为93.1%（392/421）、90.2%（92/102），差异无统计学意义（χ(2)=1.011，P=0.915）。术前纯音听阈（PTA）为（38.4±5.3）dBHL，术后3个月PTA为（25.1±5.7）dBHL，差异有统计学意义（t=39.079，P=0.001）。术前气骨导差（ABG）为（22.4±4.3）dB，术后3个月ABG为（9.1±3.8）dB，差异有统计学意义（t=53.004，P=0.001）。523例患者中，14例（2.7%）发生中耳感染，8例（1.5%）鼓膜移位，12例（2.3%）味觉异常，35例（6.7%）耳鸣，28例（5.4%）听力下降，26例（5.0%）眩晕，33例（6.3%）再穿孔，2例（0.4%）继发胆脂瘤形成，无一例发生面瘫。内镜下鼓膜成形术是一种安全有效的手术方法，术后效果良好。
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