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慢性中耳炎的内镜下与显微镜下软骨鼓膜成形术

Endoscopic Versus Microscopic Cartilage Myringoplasty in Chronic Otitis Media.

作者信息

Daneshi Ahmad, Daneshvar Ali, Asghari Alimohamad, Farhadi Mohammad, Mohebbi Saleh, Mohseni Mohammad, Yazdani Nasrin, Mohammadi Shabahang, Hosseinzadeh Farideh

机构信息

ENT and Head & Neck Research Center , The  Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran.

Skull Base Research Center , The  Five Senses Health Institute , Iran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Otorhinolaryngol. 2020 Sep;32(112):263-269. doi: 10.22038/ijorl.2020.44015.2453.

Abstract

INTRODUCTION

Operations on the tympanic membrane of the middle ear, myringoplasty, and tympanoplasty are now widely accepted, and attempts are underway all over the world to standardize the surgical techniques. This study aimed to compare postoperative outcomes of endoscopic and microscopic cartilage myringoplasty in patients suffering from chronic otitis media (COM).

MATERIALS AND METHODS

This clinical trial study compared 130 patients with COM who underwent transcanal endoscopic myringoplasty by repairing perforation using auricular concha cartilage under general anesthesia (n=75) and conventional repairing method by postauricular incision and tympanomeatal flap elevation under microscopic surgery (n=55).

RESULTS

According to the results, there was no significant difference between the two groups in terms of hearing gain 1, 6, and 12 months after surgery (P=0.063); however, higher hearing gain scores were observed in the endoscopic group. Moreover, lower recovery time and post-operative pain were reported in patients who underwent the endoscopic approach, compared to those who treated with the conventional repairing method (P<0.001).

CONCLUSION

Endoscopic myringoplasty technique is a safe and effective way to improve hearing loss as much as the conventional method. However, due to the lower recovery time and post-operative pain, it seems to be the method of choice in myringoplasty surgery.

摘要

引言

中耳鼓膜手术、鼓膜成形术和鼓室成形术目前已被广泛接受,世界各地都在努力使手术技术标准化。本研究旨在比较慢性中耳炎(COM)患者内镜下和显微镜下软骨鼓膜成形术的术后效果。

材料与方法

本临床试验研究比较了130例COM患者,其中75例在全身麻醉下采用耳甲软骨修复穿孔的经耳道内镜鼓膜成形术,55例采用显微镜下耳后切口及鼓室鼓膜瓣掀起的传统修复方法。

结果

结果显示,两组术后1个月、6个月和12个月的听力增益无显著差异(P=0.063);然而,内镜组的听力增益得分更高。此外,与采用传统修复方法的患者相比,接受内镜手术的患者恢复时间更短,术后疼痛更轻(P<0.001)。

结论

内镜鼓膜成形术技术与传统方法一样,是改善听力损失的一种安全有效的方法。然而,由于恢复时间更短和术后疼痛更轻,它似乎是鼓膜成形术的首选方法。

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