Bajpai Sanchit, Kumar Gaurav, Kanojia Rahul Dashrath, Jaiswal Saurabh Kumar, Deshpal Brig
Department of ENT and Head & neck surgery, T.S Misra Medical College & Multispecialty hospital, Lucknow, Uttar Pradesh India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):2100-2106. doi: 10.1007/s12070-023-03781-7. Epub 2023 Apr 27.
Background: Chronic otitis media (COM) is a pathology involving the middle ear cleft characterized by discharging ear and a non-healing perforation in tympanic membrane. Different techniques have been used for closing the perforation but interlay myringoplasty has become popular among surgeons since the past few decades. Objectives: To evaluate and compare the success rate of Type-1 interlay tympanoplasty in large tympanic membrane perforation with or without cortical mastoidectomy in terms of graft take-up rate and improvement in hearing outcomes. Materials and methods: A retrospective study for the period of eighteen months with total of 90 patients further subdivided into two groups. Group I of 45 patients underwent Type-1 interlay tympanoplasty alone, and 45 patients in Group II underwent type-1 interlay tympanoplasty with cortical mastoidectomy. Results: In group I the mean pre-operative, post-operative pure tone average and air bone gap was found to be 36.49 ± 4.49, 29.24 ± 4.39 and 25.11 ± 3.15, 14.76 ± 3.12 respectively. In group II the mean pre-operative, post-operative pure tone average and air bone gap was found to be 35.60 ± 5.27, 25.96 ± 5.29 and 23.96 ± 3.76 and 13.33 ± 3.38. An independent sample t-test was performed for intergroup comparison and found to be statistically significant (p < 0.005). The graft uptake was 95.5% in group II and 82.2% in group I. Conclusion: Interlay type-1 tympanoplasty coupled with cortical mastoidectomy gives excellent results in terms air bone gap closure and graft uptake in inactive mucosal COM than Interlay type-1 tympanoplasty alone.
The online version contains supplementary material available at 10.1007/s12070-023-03781-7.
背景：慢性中耳炎（COM）是一种累及中耳裂的病理状况，其特征为耳部流脓和鼓膜穿孔不愈合。已采用不同技术来封闭穿孔，但在过去几十年间，夹层鼓膜成形术在外科医生中颇受欢迎。目的：从移植物吸收率和听力结果改善方面，评估并比较在有或无皮质乳突切除术情况下，1型夹层鼓室成形术治疗大鼓膜穿孔的成功率。材料与方法：进行一项为期18个月的回顾性研究，共90例患者，进一步分为两组。第一组45例患者仅接受1型夹层鼓室成形术，第二组45例患者接受1型夹层鼓室成形术联合皮质乳突切除术。结果：在第一组中，术前、术后纯音平均听阈及气骨导差的均值分别为36.49±4.49、29.24±4.39以及25.11±3.15、14.76±3.12。在第二组中，术前、术后纯音平均听阈及气骨导差的均值分别为35.60±5.27、25.96±5.29以及23.96±3.76、13.33±3.38。进行组间比较的独立样本t检验，发现具有统计学意义（p＜0.005）。第二组的移植物吸收率为95.5%，第一组为82.2%。结论：与单纯1型夹层鼓室成形术相比，1型夹层鼓室成形术联合皮质乳突切除术在非活动性黏膜性慢性中耳炎的气骨导差闭合和移植物吸收方面效果极佳。
在线版本包含可在10.1007/s12070-023-03781-7获取的补充材料。
