Department of Otolaryngology, The Second Affiliated Hospital of Soochow University, Soochow, 215004, People's Republic of China.
Department of Otolaryngology, Eye and ENT Hospital of Fudan University, NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, 200031, People's Republic of China.
Eur Arch Otorhinolaryngol. 2019 Oct;276(10):2721-2727. doi: 10.1007/s00405-019-05514-5. Epub 2019 Jul 4.
The best surgical method for the management of adhesive otitis media is controversial. The aim of the study was to explore the feasibility and effectiveness of tympanoplasty combined with fascia grafting catheterization in the treatment of adhesive otitis media.
This was a retrospective study of patients with adhesive otitis media and who underwent tympanoplasty combined with fascia grafting and catheterization between April 2015 and December 2016 at the Eye-Ear-Nose-Throat Hospital Affiliated to Fudan University. All injured ears were examined by pure tone audiometry at 0.5, 1 and 2 kHz before and at 3 months after operation.
Thirty-five patients (35 ears) were followed for 12-44 months. The air-conduction pure tone average was 31.7 ± 12.3 dBnHL. Hearing of 28 patients (80%) was improved to a practical level within 40 dBnHL, but 2 patients (6%) had no change in postoperative hearing. Numbers of patients with spontaneous prolapse, artificial removal of tympanic membrane ventilation tube, and unobstructed in place were 15, 12, and 8, respectively. Twenty-seven patients had perforations left after the prolapse and removal of tympanic membrane ventilation tubes, of which 22 (81%) had perforations healing by themselves. All patients had dry ears after operation, without recurrence. Thirty-three patients (94%) had dry ears within 3 months and only 2 patients (6%) for more than 6 months.
Tympanoplasty combined with fascia grafting catheterization is effective in the treatment of adhesive otitis media.
对于粘连性中耳炎的治疗,哪种手术方式最佳仍存在争议。本研究旨在探讨鼓室成形术联合筋膜瓣置管在粘连性中耳炎治疗中的可行性和有效性。
回顾性分析 2015 年 4 月至 2016 年 12 月复旦大学附属眼耳鼻喉科医院收治的粘连性中耳炎患者,所有患者均接受鼓室成形术联合筋膜瓣置管治疗。分别于术前及术后 3 个月,采用纯音测听检测所有患耳在 0.5、1、2 kHz 时的气导平均听阈。
35 例(35 耳)患者获得 12~44 个月随访。术后气导纯音听阈平均为 31.7±12.3 dBnHL。28 例(80%)患者术后听力提高至 40 dBnHL 以内实用水平,但有 2 例(6%)术后听力无变化。术后鼓膜自行脱出、人为去除鼓膜通气管、通气管在位无堵塞的患者分别为 15、12、8 例。27 例患者在去除鼓膜通气管后鼓膜穿孔,其中 22 例(81%)自行愈合。所有患者术后干耳,无复发。33 例(94%)患者术后 3 个月内干耳,2 例(6%)患者干耳时间超过 6 个月。
鼓室成形术联合筋膜瓣置管治疗粘连性中耳炎效果确切。