Momin Zoha K, Yancey Kristen L, Mitton Tanner J, Kutz Joe Walter
Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Otol Neurotol Open. 2022 Jul 20;2(3):e015. doi: 10.1097/ONO.0000000000000015. eCollection 2022 Sep.
To compare the effects of preoperative medical comorbidities and operative findings on the success of lateral graft tympanoplasty.
Retrospective chart review.
Tertiary medical center.
Ninety-six patients undergoing lateral graft tympanoplasty from December 2008 to November 2020 with at least 2 months follow-up were included. Patient demographics, comorbidities including smoking status, intraoperative findings, and healing, and hearing outcomes were recorded.
Lateral graft tympanoplasty.
The primary outcome was perforation closure. Secondary outcomes were postoperative complications and change in air-bone gap (ABG).
Ninety-nine ears (mean age 40.94 ± 18.44 years) were included. Tympanic membrane perforation closure was achieved in 92 (92.9%) ears. Perforation closure was not associated with diabetes ( > 0.99), smoking ( > 0.99), or the presence of cholesteatoma at the time of lateral graft tympanoplasty ( = 0.10). Increased age (odds ratio [OR] = 1.04, = 0.31) was also not correlated with tympanic membrane closure rate. An absent malleus resulted in a higher rate of lateralization (31.3% versus 2.1%; OR = 18.41, 95% confidence interval [CI] = 3.09-95.95, = 0.001) but not blunting (12.5% versus 4.8%; OR = 0.24, 95% CI = 0.49-12.93, = 0.24). The mean ABG improved 6.82 ± 11.33 dB ( < 0.01). History of prior tympanoplasty was associated with smaller ABG improvement following surgery (ß = 4.038, = 0.262, = 0.04) but not perforation closure (OR = 3.25, 95% CI = 0.63-16.81, = 0.24).
Diabetes, active smoking, and advancing age were not associated with adverse healing in patients undergoing lateral graft tympanoplasty. Lateralization was more common with an absent malleus.
比较术前合并症和手术发现对外侧移植鼓室成形术成功的影响。
回顾性病历审查。
三级医疗中心。
纳入了2008年12月至2020年11月期间接受外侧移植鼓室成形术且至少随访2个月的96例患者。记录患者的人口统计学信息、合并症（包括吸烟状况）、术中发现、愈合情况及听力结果。
外侧移植鼓室成形术。
主要观察指标为穿孔闭合情况。次要观察指标为术后并发症及气骨导间距（ABG）的变化。
共纳入99耳（平均年龄40.94±18.44岁）。92耳（92.9%）实现了鼓膜穿孔闭合。穿孔闭合与糖尿病（>0.99）、吸烟（>0.99）或外侧移植鼓室成形术时胆脂瘤的存在（=0.10）无关。年龄增加（优势比[OR]=1.04，=0.31）也与鼓膜闭合率无关。锤骨缺失导致外移发生率更高（31.3%对2.1%；OR=18.41，95%置信区间[CI]=3.09-95.95，=0.001），但与鼓室变钝无关（12.5%对4.8%；OR=0.24，95%CI=0.49-12.93，=0.24）。平均ABG改善了6.82±11.33dB（<0.01）。既往鼓室成形术史与术后ABG改善较小有关（ß=4.038，=0.262，=0.04），但与穿孔闭合无关（OR=3.25，95%CI=0.63-16.81，=0.24）。
糖尿病、当前吸烟及年龄增长与接受外侧移植鼓室成形术患者的不良愈合无关。锤骨缺失时外移更常见。
