Düzenli Ufuk, Bozan Nazım, Turan Mahfuz, Ağırbaş Semra, Tekeli Arzu Esen, Kıroğlu Ahmet Faruk
Department of Otorhinolaryngology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey.
Department of Anesthesiology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey.
Ear Nose Throat J. 2019 Dec;98(10):621-624. doi: 10.1177/0145561319846460. Epub 2019 Apr 29.
The main aims of tympanoplasty are eradication of chronic middle ear disease, repair of the tympanic membrane, and restoration of hearing. Nitrous oxide (NO) is not a commonly preferred anesthetic agent for tympanoplasty because this agent may increase middle ear pressure and displace the graft. In this study, we researched the surgical outcomes of the underlay tympanoplasty performed with NO anesthesia. Patients who underwent tympanoplasty were included in this prospective study. A type 1 tympanoplasty was performed in all patients using the underlay technique. Patients were randomized to groups that did and did not receive NO. Preoperative and postoperative hearing thresholds were evaluated, postoperative pain scores were recorded, and the differences between the groups were statistically evaluated. There were 44 patients who received NO and 44 who did not. The graft success rate was 93.2% in the NO-receiving group and 84.1% in the nonreceiving group ( > .05). Hearing levels improved significantly after surgery in each group ( < .05), but the difference between the groups was not significant ( > .05). The postoperative pain score was 3.72 ± 1.3 in the NO-receiving group and 4.45 ± 2.3 in the nonreceiving group ( > .05). Nitrous oxide is a cheap, safe, and readily available anesthetic agent that provides acceptable success rates in patients undergoing tympanoplasty.
鼓室成形术的主要目的是根除慢性中耳疾病、修复鼓膜和恢复听力。氧化亚氮（NO）不是鼓室成形术常用的麻醉剂，因为这种药物可能会增加中耳压力并使移植物移位。在本研究中，我们研究了在NO麻醉下进行的内植法鼓室成形术的手术效果。接受鼓室成形术的患者被纳入这项前瞻性研究。所有患者均采用内植法技术进行Ⅰ型鼓室成形术。患者被随机分为接受和未接受NO的组。评估术前和术后听力阈值，记录术后疼痛评分，并对组间差异进行统计学评估。有44例患者接受了NO，44例未接受。接受NO组的移植物成功率为93.2%，未接受组为84.1%（P>0.05）。每组术后听力水平均有显著改善（P<0.05），但组间差异不显著（P>0.05）。接受NO组的术后疼痛评分为3.72±1.3，未接受组为4.45±2.3（P>0.05）。氧化亚氮是一种廉价、安全且易于获得的麻醉剂，在接受鼓室成形术的患者中可提供可接受的成功率。
