Department of Otolaryngology Head and Neck Surgery, The Head and Neck Center, Rappaport Institute of Medicine and Research, Rambam Healthcare Campus, The Technion, Israel Institute of Technology, Haifa, Israel.
Technion School of Medicine, Haifa, Israel.
Eur Arch Otorhinolaryngol. 2021 Oct;278(10):3715-3722. doi: 10.1007/s00405-020-06439-0. Epub 2020 Oct 27.
To compare the efficacy of the inlay, composite chondroperichondrial clip (triple-C) tympanoplasty with conventional underlay cartilage island tympanoplasty, and to evaluate its efficacy in treating large, marginal perforations.
The study involved 183 patients that were selected from a retrospective chart review of tympanoplasties performed at our center from March 2016 to June 2018.
A tertiary referral center hospital.
65 patients underwent inlay, triple-C cartilage tympanoplasty (inlay group) and 118 underwent underlay cartilage island tympanoplasty (underlay group).
Postoperative anatomical success rate, surgical time, hearing outcomes, and complications were analyzed. Focused analysis was performed on large or marginal perforations.
Both groups exhibited similar characteristics in demographic distribution, general health status, preoperative anatomical and hearing disabilities. Excellent results were achieved in both groups. Re-perforation occurred for 9.2% of the inlay group and 7.6% of the underlay group (p = 0.71). Hearing improvement was significant in both groups. Within the separate groups, 36% of underlay patients and 60% of inlay patients improved to achieve closure of the air-bone gap (ABG) to less than 10 dB (p = 0.1). In large or marginal perforations, both groups performed similarly. No significant complications were seen in this cohort. Nevertheless, a significant reduction in surgical time was observed in the inlay group (38 min. vs 58 min.; p = 0.0004).
Inlay triple-C tympanoplasty is comparable to conventional underlay cartilage island tympanoplasty in both anatomical and audiological success rates, even for large, marginal perforations. Due to its shorter operation time, inlay triple-C tympanoplasty should be considered a good surgical option for all tympanic membrane perforations.
比较嵌片、复合软骨肋软骨夹（三 C）鼓室成形术与传统软骨下岛状鼓膜成形术的疗效，并评估其治疗大边缘穿孔的效果。
这项研究纳入了 183 例患者，他们是从 2016 年 3 月至 2018 年 6 月在我们中心进行的鼓室成形术回顾性图表审查中选择的。
三级转诊中心医院。
65 例患者行嵌片、三 C 软骨鼓膜成形术（嵌片组），118 例行软骨下岛状鼓膜成形术（软骨下组）。
分析术后解剖成功率、手术时间、听力结果和并发症。对大穿孔或边缘穿孔进行了重点分析。
两组在人口统计学分布、总体健康状况、术前解剖和听力障碍方面具有相似的特征。两组均取得了良好的结果。嵌片组再穿孔率为 9.2%，软骨下组为 7.6%（p=0.71）。两组听力均有显著改善。在单独的组内，36%的软骨下组患者和 60%的嵌片组患者听力改善，使气骨导差（ABG）闭合至 10dB 以下（p=0.1）。在大穿孔或边缘穿孔中，两组的效果相似。该队列中未观察到明显的并发症。然而，嵌片组的手术时间显著缩短（38 分钟 vs 58 分钟；p=0.0004）。
嵌片三 C 鼓室成形术在解剖学和听力成功率方面与传统软骨下岛状鼓膜成形术相似，即使是大穿孔或边缘穿孔。由于手术时间较短，嵌片三 C 鼓室成形术应被视为所有鼓膜穿孔的良好手术选择。
