Dave Vishal, Sharma Suktara
Department of ENT, GCS Medical College, Ahmedabad, India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1232-1237. doi: 10.1007/s12070-018-1286-7. Epub 2018 Feb 23.
To evaluate graft epithelialization and hearing outcome in type 1 revision tympanoplasty using fascia lata and cartilage as graft material. In this study 33 revision cases of dry central perforations were divided into two groups, group 1 (n = 21) in which cartilage was used as a graft and group 2 (n = 12) in which fascia lata was used. Group 1 patients were divided according to the technique used as group 1a (n = 16) cartilage perichondrium composite island graft and group 1b (n = 5) cartilage butterfly inlay graft. Patients were followed up for at least 12 months postoperatively, mean 15.63 (± 4.21) months. Outcome among the two groups were measured and compared in terms of graft epithelization and hearing improvement measured as the difference between pre and post operative mean air bone gap (ABG) at 1 year. The graft epithelialization of group 1 was 85.72% (87.5% group 1a/80% group 1b) and of group 2, 83.34%. Statistically no significant difference was found in the success rate between the two groups ( = 0.6). No significant difference was found in the hearing outcome as well ( = 0.44). The overall hearing improvement was significant in both groups ( = < 0.001) including the sub groups 1a and 1b separately. 21 out of 33 patients (63.63%) operated had a mean postoperative ABG of 20 db or less. The results of cartilage and fascia lata as graft are comparable in terms of graft epithelialization and hearing outcome in revision tympanoplasty.
评估在一期翻修鼓室成形术中使用阔筋膜和软骨作为移植材料时的移植物上皮化和听力结果。在本研究中，33例干性中央穿孔的翻修病例被分为两组，第1组（n = 21）使用软骨作为移植材料，第2组（n = 12）使用阔筋膜。第1组患者根据所使用的技术分为1a组（n = 16）软骨 - 软骨膜复合岛状移植和1b组（n = 5）软骨蝶形嵌体移植。患者术后至少随访12个月，平均15.63（±4.21）个月。测量并比较两组在移植物上皮化和听力改善方面的结果，听力改善以术后1年平均气骨导间距（ABG）的术前和术后差值来衡量。第1组的移植物上皮化率为85.72%（1a组87.5%/1b组80%），第2组为83.34%。两组之间的成功率在统计学上无显著差异（P = 0.6）。听力结果也无显著差异（P = 0.44）。两组包括1a和1b亚组的总体听力改善均显著（P = <0.001）。33例手术患者中有21例（63.63%）术后平均ABG为20 dB或更低。在一期翻修鼓室成形术中，软骨和阔筋膜作为移植材料在移植物上皮化和听力结果方面具有可比性。
