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超薄软骨-软骨膜复合体移植物与颞筋膜移植物行鼓膜成形术的比较:倾向评分匹配分析。

Myringoplasty With an Ultrathin Cartilage-Perichondrium Complex Graft Versus Temporalis Fascia Graft: A Propensity Score-Matched Analysis.

机构信息

Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, Xuhui District, China.

Department of Otolaryngology-Head and Neck Surgery, Fuyang People's Hospital, Fuyang City, Anhui Province.

出版信息

Otolaryngol Head Neck Surg. 2021 Jun;164(6):1287-1293. doi: 10.1177/0194599820965940. Epub 2020 Oct 13.

Abstract

OBJECTIVE

To compare endoscopic myringoplasty using the cartilage-perichondrium complex as a graft (test group) with temporalis fascia microscopic myringoplasty (control group).

STUDY DESIGN

A retrospective cohort study.

SETTING

Department of Otorhinolaryngology in a tertiary Chinese hospital.

METHODS

Data were collected on patients between 2017 and 2019. To balance the baseline characteristics between groups, we performed a propensity score-matched analysis, and 44 patients were included in each group. Hearing improvement and eardrum closure rates were compared, and risk factors affecting them were analyzed.

RESULTS

In the control and test groups, 90.90% and 86.36% of patients had a mean air-bone gap ≤20 dB after the surgery, respectively ( = .843). The air conduction (AC) threshold gain at each frequency was similar in the 2 groups ( > .05). The closure rates were 95.45% and 93.18%, respectively ( = .645). The air-bone gap improved significantly after surgery, (1, 61) = 6.729, = .012. Age, group, middle ear mucosal status, and location of the perforation did not affect the change in air-bone gap or the drum closure rate ( > .05). However, there was an interaction between the change in air-bone gap and the size of the perforation, (1, 61) = 11.067, = 0001.

CONCLUSION

Endoscopic myringoplasty using a cartilage-perichondrium complex graft is comparable with traditional surgery. Age, location of the perforation, and middle ear mucosal status did not significantly affect the change in air-bone gap or the drum closure rate. A perforation size ≥50% was always associated with a better air-bone gap improvement.

摘要

目的

比较使用软骨-软骨膜复合体移植物的内镜鼓膜成形术(实验组)与颞筋膜显微镜鼓膜成形术(对照组)。

研究设计

回顾性队列研究。

设置

中国一家三级医院耳鼻喉科。

方法

收集 2017 年至 2019 年间的患者数据。为了平衡组间的基线特征,我们进行了倾向评分匹配分析,每组纳入 44 例患者。比较听力改善和鼓膜闭合率,并分析影响它们的危险因素。

结果

在对照组和实验组中,分别有 90.90%和 86.36%的患者术后平均气骨导差≤20dB(=.843)。两组各频率的气导(AC)阈值增益相似(>.05)。闭合率分别为 95.45%和 93.18%(=.645)。术后气骨导差明显改善,(1,61)= 6.729,=.012。年龄、组别、中耳黏膜状况和穿孔位置均不影响气骨导差或鼓膜闭合率的变化(>.05)。然而,气骨导差的变化与穿孔大小之间存在交互作用,(1,61)= 11.067,= 0001。

结论

使用软骨-软骨膜复合体移植物的内镜鼓膜成形术与传统手术相当。年龄、穿孔位置和中耳黏膜状况对气骨导差或鼓膜闭合率的变化没有显著影响。穿孔大小≥50%始终与气骨导差改善更好相关。

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