Division of Otolaryngology - Head and Neck Surgery, University of Utah, USA.
Division of Otolaryngology - Head and Neck Surgery, University of Virginia, USA.
Int J Pediatr Otorhinolaryngol. 2021 Nov;150:110903. doi: 10.1016/j.ijporl.2021.110903. Epub 2021 Aug 30.
Compare outcomes between a microscopic and endoscopic technique for anterior tympanic membrane (TM) perforation.
Results of microscopic overlay (MT) and endoscopic tympanoplasty (ET) for management of anterior TM perforations from a single surgeon.
There were 28 patients in the MT group and 35 in the ET group. The mean age was 7.1 years and 10.9 years (p < 0.001) MT and ET groups respectively. There was no statistical differences in perforation location (p = 0.1), etiology (p = 0.52) or size (p = 0.1) between both groups. Mean operating time was 119.0 min and 131.0 min in the MT and ET groups respectively (p = 0.23). Follow up was 30.9 months and 9.0 months (p = 0.001) MT and ET respectively. The perforation was successfully closed in 29 patients at 6 weeks in the ET (82.9%) and 25 in the MT (89.3%), p = 0.47. Adjusting for age revealed no significant difference between groups. Long term follow up, resulted in 10 failures (28.6%) and 7 patients (25.0%) in the ET and MT groups respectively, p = 0.75. Adjusting for the follow-up period or age, there was no significant difference between groups. The change in ABG and PTA measures were not statistically different between groups.
An anteriorly based ET is a novel technique for management of anterior TM perforations. Results from this pilot study indicate that this ET approach may be an appropriate alternative to MT for difficult to repair anterior perforations. A longer follow-up will be necessary to determine its role in these perforations.
比较显微镜下和内镜下技术治疗前鼓膜（TM）穿孔的结果。
一位外科医生对显微镜下覆盖（MT）和内镜下鼓室成形术（ET）治疗前 TM 穿孔的结果进行分析。
MT 组 28 例，ET 组 35 例。MT 组和 ET 组的平均年龄分别为 7.1 岁和 10.9 岁（p<0.001）。两组穿孔位置（p=0.1）、病因（p=0.52）或大小（p=0.1）无统计学差异。MT 和 ET 组的平均手术时间分别为 119.0 分钟和 131.0 分钟（p=0.23）。MT 和 ET 组的随访时间分别为 30.9 个月和 9.0 个月（p=0.001）。ET 组 6 周时 29 例（82.9%）和 MT 组 25 例（89.3%）成功封闭穿孔，p=0.47。调整年龄后，两组无显著差异。长期随访结果显示，ET 组有 10 例（28.6%）和 MT 组有 7 例（25.0%）失败，p=0.75。调整随访时间或年龄后，两组无显著差异。两组的 ABG 和 PTA 测量值变化无统计学差异。
基于前的 ET 是治疗前 TM 穿孔的一种新方法。本初步研究结果表明，对于难以修复的前穿孔，这种 ET 方法可能是 MT 的一种合适替代方法。需要更长的随访时间来确定其在前部穿孔中的作用。
