Pandey Bhuwan Raj, Kc Poonam
Department of ENT-HNS, Lumbini Medical College, Palpa, Nepal.
Department of ENT-HNS, Ganeshman Singh Memorial Hospital and Research Center, Lalitpur, Nepal.
JNMA J Nepal Med Assoc. 2019 Nov-Dec;57(220):416-419. doi: 10.31729/jnma.4709.
Underlay technique myringoplasty is most commonly used technique to repair tympanic membrane perforation by temporalis fascia graft and Trans-tympanic pop-in technique is an another technique that allows temporalis fascia graft placement medial to tympanic membrane remnant through the perforation without the need for tympano-meatal flap elevation. This study was undertaken to find the prevalence of perforated graft in underlay and Pop-in Technique Myringoplasty.
This descriptive cross-sectional study was done at Manipal teaching hospital, Pokhara, Nepal and comprises of 86 patients between January 2014 and June 2015. Patients undergoing Underlay Trans-canal approach by tympano-meatal flap elevation and Trans-canal, Trans-tympanic pop-in technique were included. Sample size calculation was done and convenient sampling method was applied. Point estimate at 95% CI was done for binary data along with frequency and proportion. The descriptive statistical analysis was done.
The prevalence of perforated graft was 15 (17.4%) at 95% Confidence Interval (39.75-60.25%). In underlay technique there were 8 (18.60 %) perforation and 35 (81.39%) were intact while in pop-in technique there were 7 (16.27%) perforation and 36 (83.72%) were intact. The postoperative mean Pure Tone Average (PTA) of underlay was 9.53 and pop-in was 8.31. The mean Pure Tone Average (PTA) gain after underlay technique was 16.095 and pop in technique was 16.87.
Trans-tympanic pop-in myringoplasty gives similar hearing & graft uptake results when compared with tympano-meatal flap method of underlay myringoplasty done by trans-canal.
夹层技术鼓膜成形术是通过颞肌筋膜移植修复鼓膜穿孔最常用的技术,经鼓膜植入技术是另一种技术,它允许通过穿孔将颞肌筋膜移植放置在鼓膜残余物的内侧,而无需掀起鼓室-耳道皮瓣。本研究旨在探讨夹层技术和经鼓膜植入技术鼓膜成形术中移植片穿孔的发生率。
本描述性横断面研究在尼泊尔博卡拉马尼帕尔教学医院进行,纳入了2014年1月至2015年6月期间的86例患者。纳入采用经鼓室-耳道皮瓣掀起的经耳道夹层入路和经耳道、经鼓膜植入技术的患者。进行了样本量计算并采用了方便抽样方法。对二元数据进行了95%置信区间的点估计以及频率和比例计算。进行了描述性统计分析。
在95%置信区间(39.75 - 60.25%),移植片穿孔的发生率为15例(17.4%)。在夹层技术中,有8例(18.60%)穿孔,35例(81.39%)完整;而在经鼓膜植入技术中,有7例(16.27%)穿孔,36例(83.72%)完整。夹层技术术后平均纯音平均听阈(PTA)为9.53,经鼓膜植入技术为8.31。夹层技术后的平均纯音平均听阈(PTA)增益为16.095,经鼓膜植入技术为16.87。
与经耳道进行的鼓室-耳道皮瓣夹层鼓膜成形术相比,经鼓膜植入鼓膜成形术在听力和移植片吸收方面的结果相似。