Li Chen, Wang Bing, Wang Xin, Zhang Han, Li Shidong, Liu Hui, Zhang Wen
Xi'an Medical University，Xi'an，710068，China.
Department of Otorhinolaryngology Head and Neck Surgery，Shaanxi Provincial People's Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jul;35(7):617-620. doi: 10.13201/j.issn.2096-7993.2021.07.009.
To explore the difference of short-term effect of transear endoscopic tympanoplasty （type Ⅰ） in the dry and wet ear of chronic otitis media. Patients with chronic suppurative otitis media were prospectively recruited in the Department of Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital from July 2018 to July 2020. Two otoscopicians independently judged the condition of tympanic membrane and tympanic mucosa before operation. One hundred and ten patients were divided into dry ear group （n=78） and wet ear group（n=32）. The healing rate of tympanic membrane and the degree of hearing improvement were recorded at postoperative 1 month, 3 months and 6 months. Six months after operation, the healing rate of dry ear group was 97.4% （76/78）, and that of wet ear group was 96.9%（31/32） 6 months after operation, there was no significant difference in tympanic membrane healing rate between the two groups （>0.05）. The hearing of the patients in both groups was improved, and the air conduction hearing in the dry ear group increased by （10.57±8.73） dB, and decreased by （6.44±4.98） dB after operation. In the wet ear group, the air conduction hearing increased by （8.91±11.79） dB, and decreased by （6.89±6.99） dB after operation. There was no significant difference in the degree of hearing improvement between the two groups（>0.05）. For quiescent chronic otitis media without ossicular chain lesions, the preoperative wet ear state is not a taboo in tympanoplasty （typeⅠ）, and the postoperative tympanic membrane healing rate and hearing improvement are the same as those in dry ear surgery, and can reduce the preoperative waiting time of patients, reduce the use of antibiotics.
探讨耳内镜下Ⅰ型鼓室成形术治疗慢性中耳炎干性耳与湿性耳的短期疗效差异。2018年7月至2020年7月，前瞻性纳入陕西省人民医院耳鼻咽喉头颈外科慢性化脓性中耳炎患者。两名耳镜检查医师独立判断术前鼓膜及鼓室黏膜情况。110例患者分为干性耳组（n = 78）和湿性耳组（n = 32）。记录术后1个月、3个月和6个月时鼓膜愈合率及听力改善程度。术后6个月，干性耳组愈合率为97.4%（76/78），湿性耳组为96.9%（31/32），两组鼓膜愈合率差异无统计学意义（>0.05）。两组患者听力均有改善，干性耳组术后气导听力提高（10.57±8.73）dB，下降（6.44±4.98）dB；湿性耳组术后气导听力提高（8.91±11.79）dB，下降（6.89±6.99）dB，两组听力改善程度差异无统计学意义（>0.05）。对于静止期无听骨链病变的慢性中耳炎，术前湿性耳状态不是Ⅰ型鼓室成形术的禁忌证，术后鼓膜愈合率及听力改善与干性耳手术相同，且可减少患者术前等待时间，减少抗生素使用。
