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颞面移植支撑1型鼓室成形术中前鼓室耳道角对听力结果及早期移植成功率的影响

Effect of Supporting Anterior Tympanomeatal Angle with Temporofacial Graft in Type 1 Tympanoplasty on Hearing Results and Graft Success in Early Period.

作者信息

Keskin Serhan, Tatlıpınar Arzu, Beyazgün Vehip, Dündar Tuğba Aslan

机构信息

Health Sciences University Fatih Sultan Mehmet Health Practice and Research Center, İstanbul, Turkey.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):2966-2973. doi: 10.1007/s12070-023-03914-y. Epub 2023 Jun 2.

DOI:10.1007/s12070-023-03914-y
PMID:37974732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10646111/
Abstract

The treatment of persistent tympanic membrane perforation is tympanoplasty. Presence of perforation in the anterior annulus of the patients undergoing tympanoplasty surgery is a commonly encountered problem in the postoperative period. In this study, we investigated the effects of supporting anterior tympanomeatal angle with a secondary layer of temporal muscle fascia graft in the patients undergoing type 1 tympanoplasty on postoperative hearing outcomes and early graft success. Twenty-seven patients from our clinic who underwent surgery due to chronic otitis media (COM) and whose anterior tympanomeatal angles were supported with temporal muscle fascia graft as a secondary layer were included in the study. Twelve of the patients were male and 15 of them were female. The mean age of the patients was 43,1 years. The data obtained with retrospective investigations of the patient files were statistically analyzed. Audiological results of 27 patients were obtained in the postoperative 3rd month and were compared with the preoperative results. Preoperative pure tone average of bone-conduction and air conduction were 14,68 ± 7,08 dB and 41,63 ± 9,83 dB, respectively. Postoperative pure tone averages of bone-conduction and air conduction were determined to be 15,02 ± 6,40 dB and 26,38 ± 12,79 dB, respectively. The grafts of all patients were intact at the postoperative 3rd month. We can describe the technique we used as modified sandwich tympanoplasty. In this study we found that in patients that undergoing type 1 tympanoplasty, supporting the anterior tympanomeatal angle with temporal muscle fascia graft as a secondary layer is successful in terms of hearing outcomes and graft success.

摘要

持续性鼓膜穿孔的治疗方法是鼓室成形术。在接受鼓室成形术的患者中,鼓膜前环存在穿孔是术后常见的问题。在本研究中,我们调查了在接受Ⅰ型鼓室成形术的患者中,用颞肌筋膜移植的第二层支撑鼓膜前鼓室角对术后听力结果和早期移植物成功的影响。本研究纳入了27例因慢性中耳炎(COM)在我们诊所接受手术且用颞肌筋膜移植作为第二层支撑鼓膜前鼓室角的患者。其中12例为男性,15例为女性。患者的平均年龄为43.1岁。对通过回顾性调查患者档案获得的数据进行了统计分析。在术后第3个月获得了27例患者的听力学结果,并与术前结果进行了比较。术前骨导和气导的纯音平均值分别为14.68±7.08dB和41.63±9.83dB。术后骨导和气导的纯音平均值分别确定为15.02±6.40dB和26.38±12.79dB。所有患者的移植物在术后第3个月时均完整。我们可以将我们使用的技术描述为改良三明治式鼓室成形术。在本研究中,我们发现,在接受Ⅰ型鼓室成形术的患者中,用颞肌筋膜移植作为第二层支撑鼓膜前鼓室角在听力结果和移植物成功方面是成功的。

相似文献

1
Effect of Supporting Anterior Tympanomeatal Angle with Temporofacial Graft in Type 1 Tympanoplasty on Hearing Results and Graft Success in Early Period.颞面移植支撑1型鼓室成形术中前鼓室耳道角对听力结果及早期移植成功率的影响
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):2966-2973. doi: 10.1007/s12070-023-03914-y. Epub 2023 Jun 2.
2
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Otolaryngol Head Neck Surg. 2005 Apr;132(4):532-6. doi: 10.1016/j.otohns.2004.10.018.
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Comparison of temporal muscle fascia and tragal cartilage perichondrium in endoscopic type 1 tympanoplasty with limited elevation of tympanomeatal flap.比较内镜式 1 型鼓室成形术中颞肌筋膜与耳屏软骨软骨膜在鼓室切开瓣有限抬高时的应用。
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Eur Arch Otorhinolaryngol. 2012 Apr;269(4):1117-26. doi: 10.1007/s00405-011-1779-4. Epub 2011 Oct 4.
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Comparison between clinical and audiological results of tympanoplasty with double layer graft (modified sandwich fascia) technique and single layer graft (underlay fascia and underlay cartilage) technique.采用双层移植物(改良三明治筋膜)技术和单层移植物(衬里筋膜和衬里软骨)技术进行鼓室成形术的临床和听力学结果比较。
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本文引用的文献

1
Double-Layer Tympanic Membrane Graft in Type I Tympanoplasty.I型鼓室成形术中的双层鼓膜移植术
Ann Otol Rhinol Laryngol. 2019 Sep;128(9):795-801. doi: 10.1177/0003489419843551. Epub 2019 Apr 16.
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Comparison of temporalis fascia and tragal cartilage grafts in type 1 tympanoplasty in elderly patients.老年患者1型鼓室成形术中颞肌筋膜与耳屏软骨移植的比较
Auris Nasus Larynx. 2019 Jun;46(3):319-323. doi: 10.1016/j.anl.2018.09.003. Epub 2018 Sep 14.
3
Cartilage rim augmented fascia tympanoplasty: a more effective composite graft model than temporalis fascia tympanoplasty.软骨边缘增强筋膜鼓室成形术:一种比颞肌筋膜鼓室成形术更有效的复合移植模型。
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Overlay versus underlay myringoplasty: report of outcomes considering closure of perforation and hearing function.覆盖式与衬里式鼓膜成形术:考虑穿孔闭合和听力功能的结果报告。
Acta Otorhinolaryngol Ital. 2011 Dec;31(6):366-71.
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Revision tympanoplasty including anterior perforations and lateralization of grafts.包括前部穿孔和移植物侧移的翻修鼓室成形术。
Otolaryngol Clin North Am. 2006 Aug;39(4):661-75, v. doi: 10.1016/j.otc.2006.04.001.
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Over-under tympanoplasty.夹层鼓室成形术
Laryngoscope. 2002 May;112(5):802-7. doi: 10.1097/00005537-200205000-00007.
7
Tympanoplasty with and without mastoidectomy for non-cholesteatomatous chronic otitis media.伴有或不伴有乳突切除术的鼓室成形术治疗非胆脂瘤性慢性中耳炎。
Eur Arch Otorhinolaryngol. 2001 Jan;258(1):13-5. doi: 10.1007/pl00007516.
8
Myringoplasty: update on onlay pedicle skin flap and temporalis fascia sandwich graft.鼓膜成形术:带蒂耳屏皮肤瓣及颞肌筋膜夹层移植术的进展
J Laryngol Otol. 2000 Mar;114(3):174-7. doi: 10.1258/0022215001905274.
9
Overlay versus underlay tympanoplasty. Part I: historical review of the literature.覆盖法与夹层法鼓室成形术。第一部分:文献历史回顾
Laryngoscope. 1997 Dec;107(12 Pt 2):1-25. doi: 10.1097/00005537-199712001-00001.
10
Findings in surgery for chronic otitis media. A retrospective data-analysis of 2225 cases followed for 2 years.慢性中耳炎手术的研究结果。对2225例患者进行为期2年的回顾性数据分析。
Clin Otolaryngol Allied Sci. 1983 Jun;8(3):151-8. doi: 10.1111/j.1365-2273.1983.tb01419.x.