Shrestha Bikash Lal, Dhakal Ashish, Pradhan Akash, Pokharel Monika, Rajbhandari Pradeep, Kc Abha Kiran, Shrestha Krishna Sunadar
Department of Otorhinolaryngology, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal.
Iran J Otorhinolaryngol. 2021 Sep;33(118):291-299. doi: 10.22038/ijorl.2021.54372.2857.
The use of the endoscope in otological surgeries has both diagnostic and therapeutic values. It provides an excellent view in difficult nooks and corners. The use of endoscopic sandwich myringoplasty using cartilage and perichondrium has its benefit in hearing outcome and graft uptake in long-term follow-up. The main objective was to compare the long-term with short- term hearing outcomes in those who have undergone endoscopic sandwich myringoplasty with Dhulikhel hospital (D‑HOS) technique.
Forty-two patients who underwent endoscopic sandwich myringoplasty with D-HOS technique using tragal cartilage perichondrium were enrolled in the study. The hearing outcome was analyzed by comparing the pre-operative findings with post-operative findings and amongst post-operative patients, long-term with short-term air bone gap (ABG) and ABG closure in speech frequencies (0.5kHz, 1kHz, 2kHz, 4kHz) were compared.
Amongst forty-two patients, 40 (95.2%) had graft uptake in both short-term (6.08 months) and in long-term (20 months) follow-up. The mean pre-operative ABG was 28.1±9.3dB whereas the mean short-term post-operative ABG was 14.5±7.2dB, it showed statistical significance (P=0.001). Likewise, while comparing pre-operative with long-term post-operative ABG (13.4±4.8 dB), it showed statistical significance of P=0.000. While comparing short-term with long-term post-operative ABG, it did not show any statistical significance (P=0.065).The mean closure in ABG in both short-term and long-term hearing assessment was not statistically significant (P=0.077).
Endoscopic sandwich myringoplasty with D-HOS technique is a reliable procedure with good hearing outcome and graft uptake in both short and long-term follow-up.
耳科手术中使用内窥镜具有诊断和治疗价值。它能在难以触及的角落提供极佳视野。采用软骨和软骨膜的内窥镜夹层鼓膜成形术在长期随访中对听力结果和移植物吸收有好处。主要目的是比较采用杜利凯尔医院（D-HOS）技术进行内窥镜夹层鼓膜成形术患者的长期和短期听力结果。
42例采用耳屏软骨膜通过D-HOS技术进行内窥镜夹层鼓膜成形术的患者纳入本研究。通过比较术前和术后结果分析听力结果，并且在术后患者中，比较长期和短期气骨导间距（ABG）以及言语频率（0.5kHz、1kHz、2kHz、4kHz）的ABG闭合情况。
42例患者中，40例（95.2%）在短期（6.08个月）和长期（20个月）随访中移植物均被吸收。术前平均ABG为28.1±9.3dB，而术后短期平均ABG为14.5±7.2dB，差异具有统计学意义（P = 0.001）。同样，术前与术后长期ABG（13.4±4.8dB）比较，差异具有统计学意义，P = 0.000。短期与术后长期ABG比较，未显示出任何统计学意义（P = 0.065）。短期和长期听力评估中ABG的平均闭合情况无统计学意义（P = 0.077）。
采用D-HOS技术的内窥镜夹层鼓膜成形术是一种可靠的手术方法，在短期和长期随访中均有良好的听力结果和移植物吸收情况。
