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无缝合耳屏软骨岛鼓膜成形术:我们的经验

Sutureless Tragal Cartilage Island Tympanoplasty: Our Experience.

作者信息

Varghese George Mullonkal, Abdullah P Hafees, Sabu Nelwin Jerald

机构信息

Department of Otorhinolaryngology Head and Neck surgery, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1377-1382. doi: 10.1007/s12070-018-1438-9. Epub 2018 Jul 6.

Abstract

To evaluate graft take up and hearing improvement using the technique of tragal cartilage island in COM-mucosal type. Prospective study. A total of 258 type 1 tympanoplasty surgeries were done using tragal cartilage island graft from December 2013, to December 2015; in Jubilee Mission Medical College and Research Institute with a follow up of 1 year. Inclusion criteria-all the patients undergoing type 1 tympanoplasty for chronic otitis media (mucosal type, inactive) with an intact ossicular chain by the senior author. The youngest patient was 6 years old and the oldest was 64 years. This pattern was selected for getting a uniform pattern even though cartilage tympanoplasty can be done in other forms of COM also. Graft take up in our study was found to be 96.12% in 1 year of follow up. Closure of tympanic membrane was achieved in 248 of 258 cases. None of the patients showed retraction pockets or cholesteatoma during follow up. The average pre-op AB gap was 21.62 dB which was lowered to 4.22 dB post op. The mean gain in hearing was 17.37 dB. It is worthwhile to consider tragal cartilage island graft as an alternative to temporalis fascia.

摘要

评估在慢性中耳炎黏膜型中使用耳屏软骨岛技术的移植物吸收情况及听力改善情况。前瞻性研究。2013年12月至2015年12月期间,在朱比利使命医学院及研究所共进行了258例使用耳屏软骨岛移植物的Ⅰ型鼓室成形术,随访1年。纳入标准——所有接受Ⅰ型鼓室成形术治疗慢性中耳炎(黏膜型,静止期)且听骨链完整的患者,均由资深作者进行手术。最年轻的患者6岁,最年长的64岁。选择这种术式是为了获得统一的模式,尽管软骨鼓室成形术也可以以其他形式应用于其他类型的慢性中耳炎。在我们的研究中,随访1年时移植物吸收率为96.12%。258例中有248例鼓膜愈合。随访期间,无一例患者出现内陷袋或胆脂瘤。术前平均气骨导差为21.62dB,术后降至4.22dB。听力平均提高17.37dB。值得考虑将耳屏软骨岛移植物作为颞肌筋膜的替代物。

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本文引用的文献

3
The role of different types of grafts in tympanoplasty.不同类型移植物在鼓室成形术中的作用。
Braz J Otorhinolaryngol. 2014 Jul-Aug;80(4):275-6. doi: 10.1016/j.bjorl.2014.05.018. Epub 2014 Jun 11.
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Cartilage tympanoplasty in smokers.吸烟者的软骨鼓膜成形术。
Ann Otol Rhinol Laryngol. 2012 Oct;121(10):657-63. doi: 10.1177/000348941212101006.

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