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内镜下与耳后切口显微镜下Ⅰ型鼓室成形术临床疗效比较。

Comparison of clinical outcome between endoscopic and postauricular incision microscopic type-1 tympanoplasty.

作者信息

Zhang Yonglan, Wang Wei, Xu Kaixu, Hu Ming, Ma Yuanxu, Lin Peng

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China.

Institute of Otolaryngology of Tianjin, Tianjin, China.

出版信息

Acta Otolaryngol. 2021 Jan;141(1):29-33. doi: 10.1080/00016489.2020.1821091. Epub 2020 Oct 6.

Abstract

BACKGROUND

Microscopic type-1 tympanoplasty (T1T) is a classical method for the treatment of chronic otitis media. However, it has its limitations. The development of otoendoscopy provided a new method for T1T.

OBJECTIVE

To investigate the difference between endoscopic T1T and microscopic T1T.

MATERIAL AND METHODS

Seventy-four patients who underwent T1T were evaluated retrospectively. About 52 cases underwent endoscopic T1T, and 22 cases accepted microscopic T1T. Parameters including operative duration, incision size, graft site, duration of postoperative hospitalization, visual analog scale (VAS) score, complications, hearing improvement, and expenses were compared.

RESULTS

Operative duration of endoscopic T1T (47.0 ± 8.2 min) was shorter than microscopic T1T (58.0 ± 9.3 min) ( < .05). The VAS score under endoscopic T1T (1.5 ± 0.2) was lower than microscopic T1T (5.6 ± 0.4) ( < .05). There was no complication during endoscopic T1T, but damage to the chorda tympani nerve (one case) was noted for microscopic T1T. There was no difference in hearing improvement between endoscopic (15.0 ± 1.5 dB) and microscopic T1T (16.0 ± 1.1 dB). Duration of postoperative hospitalization and expenses were lower for endoscopic T1T.

CONCLUSIONS AND SIGNIFICANCE

Endoscopic T1T is a minimally invasive surgery with similar graft success rate, comparable hearing improvement, fast recovery, low cost, and high patient satisfaction compared to microscopic T1T.

摘要

背景

显微镜下Ⅰ型鼓室成形术(T1T)是治疗慢性中耳炎的经典方法。然而,它有其局限性。耳内镜的发展为T1T提供了一种新方法。

目的

探讨耳内镜下T1T与显微镜下T1T的差异。

材料与方法

回顾性评估74例行T1T的患者。约52例接受耳内镜下T1T,22例接受显微镜下T1T。比较手术时间、切口大小、移植物部位、术后住院时间、视觉模拟评分(VAS)、并发症、听力改善情况及费用等参数。

结果

耳内镜下T1T的手术时间(47.0±8.2分钟)短于显微镜下T1T(58.0±9.3分钟)(P<0.05)。耳内镜下T1T的VAS评分(1.5±0.2)低于显微镜下T1T(5.6±0.4)(P<0.05)。耳内镜下T1T无并发症发生,但显微镜下T1T有1例出现鼓索神经损伤。耳内镜下T1T(15.0±1.5dB)与显微镜下T1T(16.0±1.1dB)在听力改善方面无差异。耳内镜下T1T的术后住院时间和费用更低。

结论与意义

与显微镜下T1T相比,耳内镜下T1T是一种微创手术,移植物成功率相似,听力改善相当,恢复快,成本低,患者满意度高。

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