Department of Otolaryngol Head & Neck Surg, the First Affiliated Hospital of Hebei North University, 12 Changqing Rd, Zhangjiakou City 075000, Hebei Province, China.
Department of Otolaryngol Head & Neck Surg, the First Affiliated Hospital of Hebei North University, 12 Changqing Rd, Zhangjiakou City 075000, Hebei Province, China.
Am J Otolaryngol. 2022 Jan-Feb;43(1):103231. doi: 10.1016/j.amjoto.2021.103231. Epub 2021 Sep 15.
The objective of this study was evaluate the short-and long-term graft outcome and complications of endoscopic modified perichondrium-cartilage sandwich graft for repairing chronic subtotal and total perforations.
Prospective case series.
135 patients with chronic subtotal and total perforations who underwent endoscopic modified perichondrium-cartilage sandwich graft technique. The graft success rate, hearing outcome, and complications were evaluated at postoperative 6 and 24 months.
124 patients were finally included in this study. The graft success rate was 96.3% in subtotal perforation and 97.7% in total perforation (P = 0.874), with an overall success rate of 96.8% at postoperative 6 months. The graft success rate was 95.8% (68/71) in subtotal perforation and 94.9% (37/39) in total perforation (P = 0.795), with an overall success rate of 95.5% (105/110) at postoperative 24 months. The mean ABG improved from 28.0 ± 5.3 dB preoperatively to 14.9 ± 4.8 dB postoperatively 12 months (P < 0.05) for subtotal perforations; from 33.4 ± 7.4 dB preoperatively to 16.1 ± 2.4 dB postoperatively 12 months (P < 0.05) for total perforations. No graft-related complications (e.g., graft lateralization, significant blunting, graft medialization) were encountered during the follow-up period. Of the 110 patients, temporal bone CT revealed well pneumatization of the middle ear and mastoid region. However, graft keratin pearl was noticed in 1.8% (2/110) patients.
Endoscopic modified perichondrium-cartilage sandwich graft for repairing subtotal and total perforations had excellent short and long-term graft success rate with less time-consuming and minimal complications.
本研究旨在评估内镜下改良软骨-软骨膜三明治移植修复慢性部分和全层穿孔的短期和长期移植物效果和并发症。
前瞻性病例系列。
对 135 例慢性部分和全层穿孔患者行内镜下改良软骨-软骨膜三明治移植技术。术后 6 个月和 24 个月评估移植物成功率、听力结果和并发症。
本研究最终纳入 124 例患者。部分穿孔的移植物成功率为 96.3%（71/74），全层穿孔的移植物成功率为 97.7%（37/38）（P=0.874），术后 6 个月的总体成功率为 96.8%。部分穿孔的移植物成功率为 95.8%（68/71），全层穿孔的移植物成功率为 94.9%（37/39）（P=0.795），术后 24 个月的总体成功率为 95.5%（105/110）。部分穿孔患者术前平均气导 ABG 为 28.0±5.3dB，术后 12 个月改善至 14.9±4.8dB（P<0.05）；全层穿孔患者术前平均气导 ABG 为 33.4±7.4dB，术后 12 个月改善至 16.1±2.4dB（P<0.05）。随访期间无移植物相关并发症（如移植物侧移、明显变钝、移植物内移）。110 例患者颞骨 CT 显示中耳和乳突区充气良好，但有 1.8%（2/110）的患者发现移植物角化珠。
内镜下改良软骨-软骨膜三明治移植修复部分和全层穿孔，具有较高的短期和长期移植物成功率，耗时少，并发症少。
