Taleuan Abdelouahid, Ridal Mohamed, Elatiq Hajar, Benmansour Najib, Oudidi Abdellatif, Elalami Mohamed Amine
Otolaryngology, Head and Neck Surgery, University Hospital Hassan II, FES, MAR.
Otolaryngology, CHU Hasssan II FES - Sidi Mohammed Ben Abdellah University - Faculty of Medecinee, FEZ, MAR.
Cureus. 2023 Apr 3;15(4):e37059. doi: 10.7759/cureus.37059. eCollection 2023 Apr.
Myringoplasty remains a topical subject. Our study aims at analyzing the anatomical and functional results of cartilaginous myringoplasty, and also determining the main factors that could influence its results.
A retrospective study of 51 cases of tympanic perforations operated at the ENT department of the Hassan II University Hospital of Fez between January 2018 and November 2021. Only the patients with exclusive cartilage myringoplasty were included. The anatomical and functional results of cartilage myringoplasty were evaluated and analyzed according to several variables. The statistical analysis was performed using SPSS Statistics software.
The average age of our patients was 35, with a sex ratio of 2.45. The perforation was anterior in 58%, posterior in 12%, and central in 30% of the cases. The average pre-operative audiometric air bone gap (ABG) was 29.3 dB. The most commonly used graft was the conchal cartilage in 89% of cases. A complete cicatrization has been noticed in 92%, and at six months after surgery, a complete closure of the ABG has been observed in 43% of cases, a significant hearing improvement with an ABG between 11 and 20 dB in 24%, a hearing recovery with an ABG between 21 and 30 dB in 21%, and an ABG > 30 dB in 12% of the cases. A statically significant relationship (p<0.05) has been found between the functional or anatomical failure of the myringoplasty; the different predictive factors were: the young age (less than 16 years), the inflammatory state of the tympanic cavity, the anterior location, and large size of the perforation.
Cartilaginous myringoplasty provides good anatomical and auditory results. The pre-operative predictive factors, such as age, complete and sufficient drying of the ear, the size and location of the perforation, and the size of the used cartilage, should all be considered for a better anatomical and functional outcome.
鼓膜成形术仍然是一个热门话题。我们的研究旨在分析软骨鼓膜成形术的解剖学和功能结果，并确定可能影响其结果的主要因素。
对2018年1月至2021年11月在非斯哈桑二世大学医院耳鼻喉科接受手术的51例鼓膜穿孔病例进行回顾性研究。仅纳入单纯软骨鼓膜成形术的患者。根据几个变量对软骨鼓膜成形术的解剖学和功能结果进行评估和分析。使用SPSS统计软件进行统计分析。
我们患者的平均年龄为35岁，性别比为2.45。58%的病例穿孔位于前方，12%位于后方，30%位于中央。术前平均听力学气骨导差（ABG）为29.3dB。89%的病例最常用的移植物是耳甲软骨。92%的病例观察到完全瘢痕化，术后六个月，43%的病例观察到ABG完全闭合，24%的病例气骨导差在11至20dB之间听力显著改善，21%的病例气骨导差在从21至30dB之间听力恢复，12%的病例气骨导差>30dB。鼓膜成形术的功能或解剖失败之间存在统计学上的显著关系（p<0.05）；不同的预测因素为：年龄小（小于16岁）、鼓室炎症状态、穿孔位于前方和穿孔面积大。
软骨鼓膜成形术可提供良好的解剖学和听觉结果。为获得更好的解剖学和功能结果，应考虑术前预测因素，如年龄、耳部完全充分干燥、穿孔的大小和位置以及所用软骨的大小。
