Cho Young Sang, Park Min Hae, Han Ul Gyu, Son Se-Eun, Moon Il Joon
Department of Otorhinolaryngology-Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul South Korea.
Hearing Research Laboratory Samsung Medical Center Seoul South Korea.
Laryngoscope Investig Otolaryngol. 2022 Nov 2;7(6):2064-2068. doi: 10.1002/lio2.961. eCollection 2022 Dec.
This study aimed to evaluate the procedural outcomes and learning curve of type I endoscopic tympanoplasty (ET) performed by a single surgeon.
This was a retrospective study of 376 patients who underwent type I ET performed by a single surgeon over 7 years. We evaluated the pre/post air-bone gap (ABG), time required for surgery, changes in pain after surgery, success, and failure rate of type I ET.
Hearing results indicated an ABG of approximately 17.8 dB before surgery but decreased significantly to 9.8 dB at 6 months after surgery. The time required for the operation gradually decreased. In particular, the time required for the procedure was 67.6 min in the first year and decreased to 31.5 minutes in the fifth year, a drastic reduction. The graft failure rate up to 6 months after surgery was 13.0% and was the same for both primary and revision surgeries. Graft failure was significantly greater with increasing size of the preoperative tympanic perforation. The success rate varied depending on graft material, and the group with only acellular allogenic dermal matrix showed the lowest success rate. Postoperative pain significantly decreased from 2.01 immediately after surgery to 0.78 points the next day, and there were no severe complications during surgery.
ET produces superior cosmetic results with minimal pain and is associated with stable hearing improvement and high success rate. The operation time decreased with surgeon experience and continued to decrease until the fifth and final year of this analysis.
本研究旨在评估由单一外科医生进行的I型内镜鼓室成形术（ET）的手术效果及学习曲线。
这是一项回顾性研究，纳入了7年间由单一外科医生进行I型ET手术的376例患者。我们评估了术前/术后气骨导差（ABG）、手术所需时间、术后疼痛变化、I型ET的成功率和失败率。
听力结果显示术前ABG约为17.8 dB，但术后6个月显著降至9.8 dB。手术所需时间逐渐减少。特别是，第一年手术所需时间为67.6分钟，到第五年降至31.5分钟，大幅缩短。术后6个月内的移植物失败率为13.0%，初次手术和翻修手术相同。术前鼓膜穿孔越大，移植物失败率越高。成功率因移植物材料而异，仅使用脱细胞异体真皮基质的组成功率最低。术后疼痛从术后即刻的2.01显著降至次日的0.78分，手术期间无严重并发症。
ET具有极佳的美容效果，疼痛极小，听力改善稳定且成功率高。手术时间随外科医生经验增加而减少，直至本分析的第五年且为最后一年仍持续下降。
4级。
