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一项关于在鼓室型慢性化脓性中耳炎中行或不行外耳道成形术的Ⅰ型鼓室成形术听力结果的比较研究。

A Comparative Study to Determine Hearing Outcome in Type 1 Tympanoplasty With and Without Canaloplasty in Tubotympanic Type of Chronic Suppurative Otitis Media.

作者信息

V Nisha, Prasad K C

机构信息

Department of ENT, Sri Devaraj URS medical college, 563101 Tamaka, Kolar, Karnataka India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3344-3348. doi: 10.1007/s12070-023-03961-5. Epub 2023 Jun 21.

DOI:10.1007/s12070-023-03961-5
PMID:37974802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10645666/
Abstract

BACKGROUND

Chronic suppurative Otitis Media is a common ear infection in India. Canaloplasty done with tympanoplasty helps to remove bony overhangs and provide complete visibility of fibrous annulus of tympanic membrane.

AIM

  1. To determine the hearing outcome in chronic otitis media (mucosal type) patients undergoing type 1 tympanoplasty with canaloplasty. 2. To determine the hearing outcome in chronic otitis media (mucosal type) patients undergoing type 1 tympanoplasty without canaloplasty. 3. To compare the hearing outcome in the above mentioned 2 groups of patients.

MATERIALS AND METHODS

56 patients of 15-60 years of age with mucosal type of Chronic otitis media, with central dry perforation and intact ossicles were included in our study. They were divided into group 1 (type 1 tympanoplasty + canaloplasty) and group 2 (type 1 tympanoplasty without canaloplasty), on alternate basis. AC, BC, Air bone gap avg was assessed via pure tone audiometry at 4 frequencies preoperatively and postoperatively at 3rd and 6th month, % closure of ABG average was calculated.

RESULTS

Type 1 tympanoplasty along with canaloplasty has better hearing improvement in pure tone audiometry compared to type 1 tympanoplasty alone, as % closure of ABG at postoperative 3rd and 6th month holds significant.

CONCLUSION

The canaloplasty provides better surgical exposure via removing bony overhangs, aids in excellent functional outcome in the form of % closure of ABG. Hence canaloplasty is added as an adjunct to routinely performed aural surgeries to enhance hearing outcome.

摘要

背景

慢性化脓性中耳炎在印度是一种常见的耳部感染疾病。鼓室成形术联合外耳道成形术有助于去除骨质悬突,使鼓膜纤维环完全可见。

目的

  1. 确定接受1型鼓室成形术联合外耳道成形术的慢性中耳炎(黏膜型)患者的听力结果。2. 确定接受1型鼓室成形术但未行外耳道成形术的慢性中耳炎(黏膜型)患者的听力结果。3. 比较上述两组患者的听力结果。

材料与方法

本研究纳入了56例年龄在15至60岁之间、患有黏膜型慢性中耳炎、中央干性穿孔且听小骨完整的患者。他们被交替分为第1组(1型鼓室成形术 + 外耳道成形术)和第2组(1型鼓室成形术但未行外耳道成形术)。术前以及术后第3个月和第6个月通过纯音听力计在4个频率评估气导、骨导、气骨导间隙平均值,并计算气骨导间隙平均闭合百分比。

结果

与单纯的1型鼓室成形术相比,1型鼓室成形术联合外耳道成形术在纯音听力测定中听力改善更好,因为术后第3个月和第6个月气骨导间隙的闭合百分比具有显著意义。

结论

外耳道成形术通过去除骨质悬突提供了更好的手术视野,有助于以气骨导间隙闭合百分比的形式实现良好的功能结果。因此,外耳道成形术作为常规耳部手术的辅助手段被添加进来,以提高听力结果。

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引用本文的文献

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本文引用的文献

1
The Impact of Canalplasty on Outcomes of Medial Graft Tympanoplasty.鼓室成形术中外耳道后壁重建对中隔移植鼓室成形术结果的影响。
Otol Neurotol. 2019 Jul;40(6):761-766. doi: 10.1097/MAO.0000000000002259.
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Int J Pediatr Otorhinolaryngol. 1999 Oct 5;49 Suppl 1:S247-51. doi: 10.1016/s0165-5876(99)00170-6.
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Chronic otitis media: diagnosis and treatment.慢性中耳炎:诊断与治疗
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