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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.

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。

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