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经耳道内镜 I 型鼓室成形术中锤前韧带伴与不伴钙化的鼓膜穿孔比较。

Comparison of Tympanic Membrane Perforation With and Without Calcification of Anterior Mallear Ligament Under Transcanal Endoscopic Type I Tympanoplasty.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, 89657The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.

出版信息

Ear Nose Throat J. 2021 Jul;100(6):411-416. doi: 10.1177/01455613211010092. Epub 2021 May 16.

DOI:10.1177/01455613211010092
PMID:33993754
Abstract

OBJECTIVES

Chronic suppurative otitis media (CSOM) induced tympanic membrane perforation (TMP) can be accompanied by anterior mallear ligament (AML) calcification. So far, comparative evaluations of TMP with and without AML calcification have rarely been reported. The aim of the current study is to compare the hearing outcomes of TMP with and without calcification of AML under transcanal endoscopic type I tympanoplasty.

METHODS

Records of 67 patients diagnosed with CSOM and receiving transcanal endoscopic type I tympanoplasty were divided into the AML calcification group (Cal group, n = 31) and the non-AML calcification group (non-Cal group, n = 36). The 31 patients in the Cal group were divided into subgroup A and B according to the severity of calcification. The operation time, closure rate, and pre- and postoperative audiometric results were retrospectively collected and analyzed.

RESULTS

Preoperatively, the Cal group had higher mean air-bone gap (ABG; = .022), and ABGs at 250 Hz ( = .017) and 500 Hz ( = .008) compared with the non-Cal groups. The Cal group showed higher improvements of ABGs at 250 Hz ( = .039) and 500 Hz ( = .021) compared with the non-Cal groups postoperatively.

CONCLUSIONS

The TMP with AML calcification leads to higher ABGs at low frequencies. The hearing outcomes are similar for TMP both with and without AML calcification after surgery. Our results suggest that transcanal endoscopic type I tympanoplasty is an appropriate surgical method for TMP with AML calcification, if the lesion can be detected and completely eliminated.

摘要

目的

慢性化脓性中耳炎(CSOM)引起的鼓膜穿孔(TMP)可伴有锤骨前韧带(AML)钙化。到目前为止,关于 TMP 伴或不伴 AML 钙化的比较评估很少有报道。本研究旨在比较经耳道内镜 I 型鼓室成形术治疗 TMP 伴和不伴 AML 钙化的听力结果。

方法

回顾性分析了 67 例诊断为 CSOM 并接受经耳道内镜 I 型鼓室成形术的患者的记录,将其分为 AML 钙化组(Cal 组,n=31)和非 AML 钙化组(非 Cal 组,n=36)。根据钙化严重程度,Cal 组的 31 例患者分为 A 亚组和 B 亚组。回顾性收集并分析了手术时间、闭合率以及术前和术后的听力结果。

结果

术前,Cal 组的平均气骨导差(ABG;P =.022)和 250 Hz(P =.017)和 500 Hz(P =.008)的 ABG 均高于非 Cal 组。与非 Cal 组相比,Cal 组术后 250 Hz(P =.039)和 500 Hz(P =.021)的 ABG 改善程度更高。

结论

TMP 伴 AML 钙化可导致低频 ABG 更高。TMP 伴或不伴 AML 钙化在手术后的听力结果相似。我们的结果表明,如果能够检测到并完全消除病变,经耳道内镜 I 型鼓室成形术是治疗 TMP 伴 AML 钙化的一种合适的手术方法。

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