Department of Otorhinolaryngology, University of Health Sciences, Samsun, Turkey.
Department of Otorhinolaryngology, Samsun Training and Research Hospital, Samsun, Turkey.
Eur Arch Otorhinolaryngol. 2019 Dec;276(12):3295-3299. doi: 10.1007/s00405-019-05636-w. Epub 2019 Sep 13.
We aimed to evaluate air-bone GAP (ABG), graft success and hearing gain according to the size and location of perforation in patients who underwent endoscopic transcanal type 1 cartilage tympanoplasty due to the tympanic membrane perforation and chronic otitis media.
The 104 patients (52 male and 52 female) who underwent endoscopic transcanal type 1 cartilage tympanoplasty, were evaluated retrospectively. Tragal cartilage grafts were utilized in all patients. Perforation size/location, duration of surgery, pre-operative and post-operative (6th month) average ABG, and pure-tone audiometric results (at 500-1000-2000-4000 Hz) as well as overall graft success were evaluated.
The mean duration of surgery was 45.60 ± 17.39 min. Perforations were most frequently located in anterior quadrant with moderate sized. The post-operative air-conduction results were significantly improved at 500-1000-2000-4000 Hz frequencies. Similarly, pre-operative air-conduction pure-tone average (PTA) (35.36 ± 11.9 dB) was significantly decreased (22.34 ± 7.9 dB) after postoperative 6 months (p ≤ 0.001). The overall graft success rate was 93.2%. Moreover, pre-operative mean ABG (19.82 ± 7.4 dB) was significantly decreased (9.05 ± 4.3 dB) after postoperative 6 months (p ≤ 0.001).
Endoscopic transcanal type 1 cartilage tympanoplasty achieved a high graft success rate, and improved hearing results, regardless of the perforations' location and size. Endoscopic tympanoplasty provides high patient safety and comfort in middle-ear surgery by wide visualization, easy applicability, short-operation duration, low complication risk, and less invasive approach.
我们旨在评估因鼓膜穿孔和慢性中耳炎而行内镜经耳道 1 型耳甲腔成形术的患者的气骨导差(ABG)、移植物成活率和听力增益,并根据穿孔的大小和位置进行分析。
回顾性分析了 104 例(52 例男性,52 例女性)因鼓膜穿孔和慢性中耳炎而行内镜经耳道 1 型耳甲腔成形术的患者。所有患者均采用耳甲腔软骨移植物。评估了穿孔大小/位置、手术时间、术前和术后(6 个月)平均 ABG、纯音听力测试结果(500-1000-2000-4000Hz)以及整体移植物成活率。
手术平均时间为 45.60±17.39 分钟。穿孔最常位于前象限,大小为中等。500-1000-2000-4000Hz 频率的术后气导结果显著改善。同样,术后 6 个月,术前气导纯音平均听阈(PTA)(35.36±11.9dB)显著降低(22.34±7.9dB)(p≤0.001)。整体移植物成活率为 93.2%。此外,术后 6 个月,术前平均 ABG(19.82±7.4dB)显著降低(9.05±4.3dB)(p≤0.001)。
内镜经耳道 1 型耳甲腔成形术无论穿孔位置和大小如何,都能获得较高的移植物成活率和听力改善效果。内镜鼓室成形术通过广泛的可视化、易于应用、手术时间短、并发症风险低和微创方法,为中耳手术提供了较高的患者安全性和舒适度。