ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China.
Key Laboratory of Hearing Medicine of National Health Commission, Shanghai, People's Republic of China.
Ear Nose Throat J. 2023 Apr;102(4):NP177-NP182. doi: 10.1177/0145561321999263. Epub 2021 Mar 15.
This study compared the rate of graft success, as well as hearing improvement and dry ear time between dry ears and wet ears with otomycosis or without otomycosis in patients with chronic suppurative otitis media (CSOM) after endoscopic cartilage myringoplasty.
This retrospective study was conducted in a tertiary hospital in Shanghai. In total, 83 patients with CSOM (43 with dry ears and 40 with wet ears) were included. Among the 40 patients with CSOM and wet ears, 25 exhibited otomycosis. All patients underwent endoscopic myringoplasty, and perforations were repaired using tragal cartilage with a single-sided perichondrium. Patients were followed up for at least 6 months. Pure-tone hearing was examined preoperatively and at 3 months postoperatively. The graft uptake rate, hearing improvement, and dry ear time were compared between the groups.
The graft success rate did not differ significantly between the dry-ear and wet-ear groups (95.35% and 90.00%, respectively). Furthermore, the graft success rate also did not differ significantly between patients with wet ears and otomycosis and those with wet ears without otomycosis (92.00% and 86.67%, respectively). Hearing gain did not differ significantly between the dry-ear and wet-ear groups. No significant difference in hearing gain was also found in patients with wet ears with or without otomycosis. However, the time to dry ear was significantly longer in the wet-ear group than in the dry-ear group.
Patients with CSOM and wet ears required more time to achieve a completely healthy status. However, the graft success rate and hearing improvement were not affected by a wet middle ear and otomycosis. Thus, endoscopic myringoplasty using tragus cartilage is an effective treatment for refractory CSOM in patients with wet ears and otomycosis.
本研究比较了内镜耳软骨鼓膜成形术后慢性化脓性中耳炎（CSOM）患者干耳与湿耳伴或不伴真菌性外耳道炎患者的移植物成功率，以及听力改善和干耳时间。
本回顾性研究在上海一家三级医院进行。共纳入 83 例 CSOM 患者（干耳 43 例，湿耳 40 例）。在 40 例湿耳患者中，25 例患有真菌性外耳道炎。所有患者均行内镜鼓膜成形术，使用单侧软骨膜修复鼓膜穿孔。患者随访至少 6 个月。术前及术后 3 个月行纯音听力检查。比较两组间移植物吸收率、听力改善及干耳时间。
干耳组和湿耳组的移植物成功率无显著差异（分别为 95.35%和 90.00%）。此外，湿耳伴真菌性外耳道炎和湿耳无真菌性外耳道炎患者的移植物成功率也无显著差异（分别为 92.00%和 86.67%）。干耳组和湿耳组的听力增益无显著差异。湿耳伴或不伴真菌性外耳道炎患者的听力增益也无显著差异。然而，湿耳组的干耳时间明显长于干耳组。
CSOM 伴湿耳患者需要更长时间才能达到完全健康状态。然而，湿性中耳和真菌性外耳道炎并不影响移植物成功率和听力改善。因此，使用耳屏软骨的内镜鼓膜成形术是治疗湿性中耳伴真菌性外耳道炎和难治性 CSOM 的有效方法。
