Yue Bo, Wang Xi, Zhang Chanjuan, Qiao Yan, Yang Runqin, Song Yongli, Zha Dingjun, Chen Yang, Qiu Jianhua
Department of Otolaryngology Head and Neck Surgery,First Affiliated Hospital of Air Force Military Medical University,Xi'an,710032,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Mar;35(3):212-215. doi: 10.13201/j.issn.2096-7993.2021.03.005.
To compare the effect on hearing of different reconstruction material in type Ⅱ tympanoplasty. Retrospectively analysis of 286 patients who accepted type Ⅱ tympanoplasty. The air-bone gap of 0.5, 1, 2, 4 kHz was analyzed before and after operation. We compared the hearing change and the complications between each group. In incus group, the manubrium mallei and the head of stapes were connected with shaped incus, PORP group were implanted with PORP during operation, and cartilage group used auricular cartilage to cover the head of stapes. There was no significant difference in 4 kHz air-bone gap(ABG) between the cartilage group and PORP group either before or after the operation (>0.05). Air-bone gap of 0.5, 1, 2, 4 kHz of the incus group, and the 0.5, 1, 2 kHz of the cartilage and PORP group were significantly reducedafter the operation(<0.05). One patient got severe sensorineural hearing loss in incus group after the operation. The high frequency of bone conduction decreased in 1 patient(2, 4 kHz).In the incus group, 3 patients had temporary facial paralysis after operation. Incus and cartilage group each have 1 patient with dizziness after the operation. Incus, cartilage and PORP group had 5, 3 and 11 patients with perforation again respectively. There was extrusion occurred in 1 patient of PORP group. Self incus, cartilage and PORP can be used in typeⅡ tympanoplasty, the effect of hearing reconstruction is similar. The first two are more economical, PORP implantation has the lowest technical difficulty and the most widely application, but there is a certain risk of extrusion .
比较不同重建材料在Ⅱ型鼓室成形术中对听力的影响。回顾性分析286例行Ⅱ型鼓室成形术的患者。分析手术前后0.5、1、2、4kHz的气骨导差。比较各组之间的听力变化及并发症。砧骨组将锤骨柄与镫骨头用塑形砧骨连接,PORP组术中植入PORP,软骨组用耳软骨覆盖镫骨头。软骨组与PORP组术前及术后4kHz气骨导差(ABG)差异均无统计学意义(>0.05)。砧骨组0.5、1、2、4kHz及软骨组与PORP组0.5、1、2kHz气骨导差术后均显著降低(<0.05)。砧骨组术后1例出现重度感音神经性听力损失。1例患者骨导高频下降(2、4kHz)。砧骨组术后3例出现暂时性面瘫。砧骨组与软骨组术后各有1例患者出现头晕。砧骨组、软骨组与PORP组分别有5、3、11例患者再次出现穿孔。PORP组1例出现植入物脱出。自体砧骨、软骨及PORP均可用于Ⅱ型鼓室成形术,听力重建效果相似。前两者更经济,PORP植入技术难度最低、应用最广泛,但有一定的植入物脱出风险。