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使用耳屏软骨膜移植的Ⅰ型鼓室成形术:我们的经验。

Tympanoplasty Type-I using tragal perichondrium graft: Our experience.

作者信息

Wahid Fazal I, Nagra Sajid Rashid

机构信息

Dr. Fazal I Wahid, FCPS. Department of E.N.T, Head & Neck Surgery, Medical Teaching Institute (MTI), Lady Reading Hospital (LRH) Peshawar, Khyber Pakhtunkhwa, Pakistan.

Dr. Sajid Rashid Nagra, FCPS. Department of E.N.T, Rai Medical College Sargodha, Punjab, Pakistan.

出版信息

Pak J Med Sci. 2019 Jul-Aug;35(4):1076-1080. doi: 10.12669/pjms.35.4.421.

Abstract

OBJECTIVE

To determine the efficacy of tragal perichondrium graft used in tympanoplasty Type-I at a tertiary care hospital.

METHODS

This descriptive case-series study was performed at the department of E.N.T, Head and Neck Surgery, Medical Teaching Institution/Lady Reading Hospital (MTI/LRH), Peshawar, Pakistan from June 2017 to May 2018. After approved from IREB, a well informed consent was taken. Pure Tone Audiometry (PTA) was performed before surgery and post-operatively at three and six months interval. The mean ± SD Air-Bone Gap (ABG) was calculated in pre- and postoperative PTA. The data were analyzed using SPSS (version 20). Chi-square (X2) test of significance was used taking confidence interval at 95%. The p-value ≤0.05 was considered significant.

RESULTS

Total patients were 36; male 21 (58.3%), female 15(41.7%) with male: female ratio of 1.4:1. Mean ± SD age was 27.14 ± 7.49 years (Range 15 - 50Years). Tympanic membrane perforation was commonly found on right side 22 (61.1%), predominantly involving anterio-inferior site 19 (52.8%) and medium sized perforation outnumbered 22 (61.1%). Mean pre-operative air-conduction of 49.72 dB was significantly reduced to 18.27 dB with p-value of <0.05. Similarly the pre-operative mean air bone gap on PTA of 45.63 ± 8.35dB was also reduced to statistically significant level of 7.41 ± 3.51 dB on post-operative PTA with p-value of <.05. Graft was taken up well in 34 cases (94.4%).

CONCLUSION

Tragal perichondrial graft is an effective grafting material used for tympanoplasty due to its possessing qualities.

摘要

目的

在一家三级医疗机构中确定耳屏软骨膜移植物用于Ⅰ型鼓室成形术的疗效。

方法

本描述性病例系列研究于2017年6月至2018年5月在巴基斯坦白沙瓦市医学教学机构/莱迪阅读医院(MTI/LRH)的耳鼻喉头颈外科进行。经伦理审查委员会(IREB)批准后,获取了充分知情同意书。术前及术后每隔三个月和六个月进行纯音听力测定(PTA)。计算术前和术后PTA中的平均±标准差气骨导差(ABG)。使用SPSS(版本20)对数据进行分析。采用卡方(X2)显著性检验,置信区间为95%。p值≤0.05被认为具有显著性。

结果

总患者数为36例;男性21例(58.3%),女性15例(41.7%),男女比例为1.4:1。平均±标准差年龄为27.14±7.49岁(范围15 - 50岁)。鼓膜穿孔常见于右侧22例(61.1%),主要累及前下部位19例(52.8%),中等大小穿孔居多22例(61.1%)。术前平均气导49.72dB显著降至18.27dB,p值<0.05。同样,术前PTA平均气骨导差45.63±8.35dB在术后PTA中也降至统计学显著水平7.41±3.51dB,p值<0.05。34例(94.4%)移植物吸收良好。

结论

耳屏软骨膜移植物因其特性是用于鼓室成形术的一种有效移植材料。

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