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内镜下经外耳道前片瓣夹层技术鼓膜成形术:35例分析

Endoscopic transcanal myringoplasty with anterior tab flap underlay technique: An analysis of 35 cases.

作者信息

Le Thanh Thai, Vo Doan Minh Nhat, Duong Thi My, Nguyen Nguyen

机构信息

Department of Otolaryngology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Vinh Ninh Ward, Hue City, Thua Thien Hue province, Viet Nam.

出版信息

Ann Med Surg (Lond). 2022 Jul 11;80:104135. doi: 10.1016/j.amsu.2022.104135. eCollection 2022 Aug.

Abstract

INTRODUCTION

The repair of the tympanic membrane can present a problem, especially in anterior perforation, because the anterior portion was not enough to inadequate contact between tympanic membrane remnant and graft. Various surgical techniques were recommended to achieve an acceptable graft success rate in anterior perforation. Endoscopic transcanal myringoplasty with anterior tab flap could provide the better stability of the graft.

OBJECTIVE

The aim of this study was to report the minimally invasive technique for the anterior tympanic membrane perforation closure and investigate the graft success rate of this technique.

PATIENTS AND METHODS

We performed a prospective, randomized study of 35 patients who consulted the otorhinolaryngology department at the university hospital for surgery of perforation tympanic membrane repair.

RESULTS

The average age was 35.1 ± 11.9 years. The size of the perforation was dominant at small-size and large-size, 51.4%, 34.3%, respectively. There was a significant difference between the Preoperative air conduction of small and large perforations (34.44 8.68 and 49.79 14.54, respectively). Of 35 patients, 31 (88.6%) had closure of their perforations. The mean preoperative ABG was 24.11 ± 10.79 dB, while The mean postoperative ABG was 13.97 ± 10.03 dB (p < 0.05). Approximately 34.3% patients had ABG within 20 dB preoperatively, which increased to 82.9% after intervention (p < 0.05).

CONCLUSIONS

The endoscopic transcanal myringoplasty with anterior tab flap underlay technique is a safe, suitable and effective method for cases with anterior tympanic membrane perforations, and showed improvement in postoperative hearing.

摘要

引言

鼓膜修复可能会出现问题,尤其是在前部穿孔的情况下,因为前部组织不足,导致鼓膜残余与移植物之间接触不良。人们推荐了各种手术技术,以在前部穿孔中获得可接受的移植物成功率。带前片瓣的内镜经耳道鼓膜成形术可以为移植物提供更好的稳定性。

目的

本研究的目的是报告鼓膜前部穿孔闭合的微创技术,并研究该技术的移植物成功率。

患者和方法

我们对35名到大学医院耳鼻喉科咨询鼓膜穿孔修复手术的患者进行了一项前瞻性随机研究。

结果

平均年龄为35.1±11.9岁。穿孔大小以小穿孔和大穿孔为主,分别占51.4%和34.3%。小穿孔和大穿孔术前气导之间存在显著差异(分别为34.44±8.68和49.79±14.54)。35例患者中,31例(88.6%)穿孔闭合。术前平均ABG为24.11±10.79dB,术后平均ABG为13.97±10.03dB(p<0.05)。术前约34.3%的患者ABG在20dB以内,干预后增加到82.9%(p<0.05)。

结论

带前片瓣的内镜经耳道鼓膜成形术衬里技术是治疗鼓膜前部穿孔病例的一种安全、合适且有效的方法,并且术后听力有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc09/9283794/a232d6963d6f/gr1.jpg

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