Li Xiping, Chen Zhiting, Huang Xiaobing, Zhang Jing, Wei Yongxiang
Department of Otorhinolaryngology Head and Neck Surgery,Beijing Anzhen Hospital Affiliated with Capital Medical University,Beijing,100029,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Oct;34(10):878-883. doi: 10.13201/j.issn.2096-7993.2020.10.004.
To explore the feasibility of transcanal endoscopic ear surgery for tympanosclerosis as well as the surgical method and short-term effect. Forty-one patients with type Ⅱ-Ⅳ tympanosclerosis who underwent transcanal endoscopic ear surgery were retrospectively analysed. All the tympanosclerotic lesions were removed with endoscope, then tympanoplasty was performed according to the ossicular involvement. Postoperative examination and audiometry were performed at 1, 3 and 6 months after the operation. Pre-and post-operative(6 months as the final result) pure tone air-bone gap were compared between different types of tympanosclerosis to evaluate the short-term effect, the difference of hearing improvement between different type of tympanoplasties was also compared. SPSS 22.0 was used for statistical analysis. Forty-three ears recovered without complications, except one with marginal performation, the graft take rate was 97.7%. The preoperative and 6 months postoperative air-bone gap was (36.73±11.68) dB and (20.55±10.27) dB respectively, with significant difference(=20.476, <0.05). There were no significant differences in hearing improvement among the three types, though the hearing improvement of Type Ⅲ typanosclerosis was worse than that of type Ⅱ and Ⅳ. There was no significant difference in the hearing improvement between type Ⅱ and Ⅲ tympanoplasty(>0.05). Transcanal endoscopic surgery is safe and effective for tympanosclerosis with satisfying short-term effect, though long-term result still needs further investigation.
探讨经耳道内镜耳手术治疗鼓室硬化症的可行性、手术方法及短期疗效。回顾性分析41例接受经耳道内镜耳手术的Ⅱ-Ⅳ型鼓室硬化症患者。在内镜下清除所有鼓室硬化病变,然后根据听骨受累情况行鼓室成形术。术后1、3和6个月进行检查及听力测试。比较不同类型鼓室硬化症术前及术后(以6个月为最终结果)的纯音气骨导差,以评估短期疗效,同时比较不同类型鼓室成形术听力改善的差异。采用SPSS 22.0进行统计分析。43耳恢复良好,无并发症,仅1例有边缘穿孔,移植物成活率为97.7%。术前及术后6个月气骨导差分别为(36.73±11.68)dB和(20.55±10.27)dB,差异有统计学意义(=20.476,<0.05)。三种类型的听力改善情况无显著差异,尽管Ⅲ型鼓室硬化症的听力改善比Ⅱ型和Ⅳ型差。Ⅱ型和Ⅲ型鼓室成形术的听力改善无显著差异(>0.05)。经耳道内镜手术治疗鼓室硬化症安全有效,短期疗效满意,但其长期疗效仍需进一步研究。