Department of Otolaryngology, Hangzhou Hospital of Traditional Chinese Medicine, China; Department of Otolaryngology, Hangzhou TCM Hospital Affiliated to Zhejian Chinese Medicine University, China.
Am J Otolaryngol. 2022 Mar-Apr;43(2):103307. doi: 10.1016/j.amjoto.2021.103307. Epub 2021 Dec 3.
The objective of this study was to evaluate the graft outcome and complications of endoscopic perichondrium-cartilage button technique for repairing chronic large perforations in teenagers.
Prospective case series.
56 patients with chronic large perforations more than 50% of the TM who underwent endoscopic perichondrium-cartilage button technique. The graft success rate, hearing outcome, and complications were evaluated at postoperative 3, 6 and 12 months.
Of the 56 ears, 3 (5.4%) patients lost follow-up, 53 (94.6%) patients were finally included in this study. The mean operation time was 37.2 ± 5.4 min. The retrograde tympanomeatal flap elevation was performed in 16 (30.2%) patients. The graft success rate was 96.2% (51/53) at postoperative 3 months and 94.3% (50/53) at postoperative 12 months. The mean preoperative ABG was 25.0 ± 3.7 dB, while the mean postoperative ABG postoperatively 6 months was 12.8 ± 3.1 dB; the difference between these values was significant. No graft-related complications (e.g., graft lateralization, significant blunting, and graft medialization) were encountered during the follow-up period. However, graft keratin pearl was noticed in 5.7% (3/53) patients, which occurred in the handle of malleus in 2 and antero-inferior margin in one. All the graft pearls were endoscopically removed in the outpatient setting.
Endoscopic perichondrium-cartilage button technique can be achieved in every teenager patient with chronic large perforation without cholesteatoma, and, is a safe and efficient procedure.
本研究旨在评估内镜耳软骨膜-软骨瓣技术修复青少年慢性大穿孔的移植物效果和并发症。
前瞻性病例系列。
56 例 TM 慢性大穿孔>50%的患者接受了内镜耳软骨膜-软骨瓣技术。术后 3、6 和 12 个月评估移植物成功率、听力结果和并发症。
56 耳中，3 例（5.4%）患者失访，最终 53 例（94.6%）患者纳入研究。平均手术时间为 37.2±5.4 分钟。16 例（30.2%）患者行逆行鼓室-鼓膜瓣掀起术。术后 3 个月移植物成功率为 96.2%（51/53），术后 12 个月为 94.3%（50/53）。术前平均 ABG 为 25.0±3.7dB，术后 6 个月平均 ABG 为 12.8±3.1dB，差异有统计学意义。随访期间未发生移植物相关并发症（如移植物侧移、明显变钝和移植物内移）。然而，5.7%（3/53）患者出现移植物角化珠，2 例发生在锤骨柄，1 例发生在前下缘。所有移植物珠均在门诊经内镜取出。
内镜耳软骨膜-软骨瓣技术可用于治疗无胆脂瘤的青少年慢性大穿孔患者，是一种安全有效的手术方法。
