Bhardwaj Bhanu, Singh Jaskaran
1Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, 27-C, Sant Avenue, The Mall, Amritsar, 143001 India.
2Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, HIG 202, Sector-71, Mohali, 160071 India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1174-1178. doi: 10.1007/s12070-018-1248-0. Epub 2018 Feb 9.
Tympanic Membrane perforation is a common cause of hearing loss. Various surgical techniques with different types of graft materials have been described for the treatment of perforations. The conchal cartilage and temporalis fascia graft are most widely used. We conducted a prospective Randomized control trial at Sri Guru Ram Das Institute of Medical Sciences and Research to compare the post operative hearing outcomes between the patients of safe CSOM (n = 40) using temporalis fascia (n = 20) and conchal cartilage (n = 20). It was found that the AB gap closure at 2 months post-operatively was 11.55 ± 8.173 for conchal perichondrium group as compared to 10.49 ± 9.069 for temporalis fascia group. At 6 months the AB gap closure was 14.98 ± 9.915 for conchal cartilage group as compared 11.41 ± 8.288 db for temporalis fascia group. Thus hearing improvement was better for conchal cartilage group both at 2 and 6 months but the comparison of the AC gain at the end of 6 months and subjective improvement in hearing between the two techniques was not statistically significant owing to the small sample size of the study. Both Temporalis fascia and conchal cartilage with perichondrium were acceptable graft material for successful closure of tympanic membrane perforation, hearing improvement was better with conchal cartilage group.
鼓膜穿孔是听力损失的常见原因。已经描述了各种使用不同类型移植材料的外科技术来治疗穿孔。耳甲软骨和颞肌筋膜移植是最广泛使用的。我们在斯里古鲁·拉姆·达斯医学科学与研究学院进行了一项前瞻性随机对照试验,以比较使用颞肌筋膜(n = 20)和耳甲软骨(n = 20)的安全慢性化脓性中耳炎患者(n = 40)术后的听力结果。结果发现,术后2个月时,耳甲软骨膜组的气骨导差闭合为11.55±8.173,而颞肌筋膜组为10.49±9.069。6个月时,耳甲软骨组的气骨导差闭合为14.98±9.915,而颞肌筋膜组为11.41±8.288dB。因此,耳甲软骨组在2个月和6个月时听力改善均更好,但由于研究样本量小,两种技术在6个月末的气导增益比较和听力主观改善在统计学上无显著差异。颞肌筋膜和带软骨膜的耳甲软骨都是成功闭合鼓膜穿孔可接受的移植材料,耳甲软骨组听力改善更好。