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使用强化耳廓软骨切片比较小、中、大穿孔的I型软骨鼓膜成形术的短期和长期移植物摄取及听力结果。

To Compare Short and Long-Term Graft Uptake and Hearing Outcome of Type I Cartilage Tympanoplasty Between Small, Medium and Large Perforations Using Reinforced Sliced Conchal Cartilage.

作者信息

Singh Satinder Pal, Nagi Ravinder Singh, Singh Jagdeepak

机构信息

1Department of ENT and Head Neck Surgery, Government Medical College Amritsar, H. No. 4580, Bhalla Colony, Chheharta, Amritsar, Punjab India.

2Department of ENT and Head Neck Surgery, Government Medical College Amritsar, E-130, Ranjit Avenue, Amritsar, Punjab India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Dec;71(4):550-556. doi: 10.1007/s12070-019-01727-6. Epub 2019 Aug 13.

Abstract

To compare short and long-term graft uptake and hearing outcome of type I cartilage tympanoplasty between small, medium and large perforations using reinforced sliced conchal cartilage. A retrospective study conducted in a tertiary center. Fifty patients who under went type I tympanoplasty were enrolled. Their mean age was 29.30 years and follow-up time was 6 and 18 months. The preoperative, postoperative short-term and long-term hearing and graft uptake results were analyzed. Graft uptake rate was 96% in short-term and 98% in long-term with one residual perforation in medium size, but 100% in small and large perforations ( < 0.01). Short and long-term ABG closure was identical in small and medium size perforation ( = 0.978) ( = 0.734), but, large perforation showed significant improvement in long-term ( = 0.012). Sliced conchal cartilage reinforced with temporalis fascia is a reliable technique for tympanoplasty. In long-term, large perforations have better graft uptake rate and continuous hearing improvement and ABG closure than small and medium perforations.

摘要

使用加固的耳廓软骨切片,比较小、中、大穿孔的I型软骨鼓膜成形术的短期和长期移植物摄取及听力结果。在一家三级中心进行了一项回顾性研究。纳入了50例行I型鼓膜成形术的患者。他们的平均年龄为29.30岁,随访时间为6个月和18个月。分析了术前、术后短期和长期的听力及移植物摄取结果。短期移植物摄取率为96%,长期为98%,中穿孔有1例残余穿孔,但小穿孔和大穿孔的摄取率为100%(P<0.01)。小穿孔和中穿孔的短期和长期气骨导差闭合情况相同(P=0.978)(P=0.734),但大穿孔在长期显示出显著改善(P=0.012)。用颞肌筋膜加固的耳廓软骨切片是一种可靠的鼓膜成形术技术。长期来看,大穿孔比小穿孔和中穿孔具有更好的移植物摄取率、持续的听力改善和气骨导差闭合。

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本文引用的文献

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Tympanoplasty--conchal cavum approach.鼓室成形术——外耳道上隐窝入路。
J Otolaryngol Head Neck Surg. 2016 Jan 6;45:1. doi: 10.1186/s40463-015-0113-3.
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Cartilage "shield" tympanoplasty: an effective and practical technique.软骨“盾牌”鼓室成形术:一种有效且实用的技术。
Eur Arch Otorhinolaryngol. 2014 Jul;271(7):1903-8. doi: 10.1007/s00405-013-2679-6. Epub 2013 Sep 3.
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Cartilage tympanoplasty methods: proposal of a classification.软骨鼓膜成形术方法:一种分类建议
Otolaryngol Head Neck Surg. 2008 Dec;139(6):747-58. doi: 10.1016/j.otohns.2008.09.021.
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Cartilage tympanoplasty.软骨鼓膜成形术
Otolaryngol Clin North Am. 2006 Dec;39(6):1161-76. doi: 10.1016/j.otc.2006.08.006.

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