Lee Sungsu, Cho Hyong-Ho
Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Clin Exp Otorhinolaryngol. 2020 Feb;13(1):41-46. doi: 10.21053/ceo.2019.00318. Epub 2019 Aug 3.
To evaluate the results of transcanal endoscopic tympanoplasty for pediatric patients with chronic otitis media (COM) and compare them to that of the previously standard microscopic assisted tympanoplasty technique.
The patients were divided into two groups based on the operative method. Group 1 underwent tympanoplasty with a totally endoscopic assisted technique (n=21, 24 ears), and group 2 underwent tympanoplasty with the conventional microscopic technique (n=14, 15 ears). We used a transcanal approach in group 1 and a postauricular approach in group 2. In group 1, there were 15 cases of simple COM and nine cases of adhesive otitis media. In group 2, only 15 cases of simple COM were present. We analyzed the outcomes in terms of the hearing gain according to the surgical method and COM type, operation time, hospital stay after surgery, and graft success rate.
Postoperative hearing gain results including air conduction (AC) thresholds and air-bone gap (ABG) were not significantly different between the two groups (P>0.05). In both the groups, significant improvement in the postoperative AC and ABG was observed compared to the preoperative hearing. The hospital stay after surgery was significantly shorter in group 1 than the group 2: 2.1±0.4 days and 4.8±0.9 days (P<0.001), respectively. The intact graft success rate was 91.6% in group 1 and 93% in group 2; the values were not significantly different (P>0.05). There was neither intra- nor postoperative complications.
Transcanal endoscopic ear surgery technique is more conservative than microscopic approach and can be performed in pediatric patients under 15 years of age with COM. Moreover, it offers similar surgical results compared to traditional microscopic technique, and a shorter operative time and hospital stay after surgery are the advantages of this technique.
评估经耳道内镜鼓膜成形术治疗小儿慢性中耳炎（COM）的效果，并与之前的标准显微镜辅助鼓膜成形术技术进行比较。
根据手术方法将患者分为两组。第1组采用完全内镜辅助技术进行鼓膜成形术（n = 21，24耳），第2组采用传统显微镜技术进行鼓膜成形术（n = 14，15耳）。第1组采用经耳道入路，第2组采用耳后入路。第1组中，单纯COM 15例，粘连性中耳炎9例。第2组中，仅存在15例单纯COM。我们根据手术方法和COM类型、手术时间、术后住院时间以及移植物成功率分析听力改善情况。
两组术后听力改善结果，包括气导（AC）阈值和骨气导差（ABG），差异无统计学意义（P>0.05）。与术前听力相比，两组术后AC和ABG均有显著改善。第1组术后住院时间明显短于第2组：分别为2.1±0.4天和4.8±0.9天（P<0.001）。第1组完整移植物成功率为91.6%，第2组为93%；差异无统计学意义（P>0.05）。术中及术后均无并发症。
经耳道内镜耳外科技术比显微镜入路更保守，可用于15岁以下患有COM的小儿患者。此外，与传统显微镜技术相比，它提供了相似的手术效果，且手术时间短和术后住院时间短是该技术的优点。
