Chen Yiwei, Zhou Jianbo, Tang Yiting, Zhou Ping, Hu Bin, He Ling, Wang Ning, Xiao Xuping
Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Hunan Normal University,Hunan Provincial People's Hospital,Changsha,410005,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Apr;38(4):316-320;324. doi: 10.13201/j.issn.2096-7993.2024.04.010.
To study the difference of postoperative efficacy between two-person three-hand ear endoscopy and microscopic tympanoplasty in patients with chronic suppurative otitis media, and to explore the advantages and disadvantages of two-person three-hand ear endoscopy. A retrospective study was conducted on 100 patients who underwent tympanoplasty in the Department of Otolaryngology and Head and Neck Surgery of Hunan People's Hospital from April 2019 to March 2023, and they were divided into 2 groups with 50 cases each according to random number table method. Among them, 50 cases underwent endoscopic tympanoplasty in two-person three-hand(group A) and 50 cases underwent routine microscopic tympanoplasty(group B). The operation and postoperative conditions of the two groups were followed up. In group A, the mean operation time was(65.78±18.21) min, the mean intraoperative blood loss was(12.94±4.46) mL, the postoperative pain score was(1.82±0.60) points, and the mean postoperative hospital stay was(2.76±0.72) d. The mean operation time of group B was(89.45±20.38) min, the mean intraoperative blood loss was(22.78±5.74) mL, the postoperative pain score was(2.98±0.85) points, and the mean postoperative hospital stay was(3.82±0.75) d, which with statistical significance between the two groups(<0.05). Hearing in both groups was significantly improved 6 months after surgery, and the difference was statistically significant before and after surgery(<0.05), but there was no significant difference between the two groups before surgery and 6 months after surgery(>0.05). There were 2 cases in group A(4%) and 1 case in group B(2%) complicated with tympanic cord injury during operation, and the difference was not statistically significant(>0.05). There were 47 cases of A group(94%) of one-time healing of tympanic membrane after operation, 48 cases(96%) of group B, and the difference was not statistically significant(>0.05). There is no significant difference in cure rate and hearing improvement between two-person three-hand ear endoscopic tympanoplasty and conventional microscope surgery, and the operation time is significantly shortened, the amount of blood loss is less, and the postoperative recovery is faster. It has the advantages of clear operating field, two-person three-hand operation, minimally invasive, and can reach the range of middle ear tympanic sinus and mastoid apex, and the surgical complications are seldom, which is worth promoting.
为研究慢性化脓性中耳炎患者采用双人三手耳内镜与显微镜下鼓室成形术的术后疗效差异,探讨双人三手耳内镜的优缺点。对2019年4月至2023年3月在湖南省人民医院耳鼻咽喉头颈外科行鼓室成形术的100例患者进行回顾性研究,按随机数字表法分为2组,每组50例。其中,50例行双人三手耳内镜下鼓室成形术(A组),50例行常规显微镜下鼓室成形术(B组)。对两组的手术及术后情况进行随访。A组平均手术时间为(65.78±18.21)min,平均术中出血量为(12.94±4.46)mL,术后疼痛评分为(1.82±0.60)分,术后平均住院时间为(2.76±0.72)d。B组平均手术时间为(89.45±20.38)min,平均术中出血量为(22.78±5.74)mL,术后疼痛评分为(2.98±0.85)分,术后平均住院时间为(3.82±0.75)d,两组比较差异有统计学意义(<0.05)。两组术后6个月听力均明显改善,手术前后差异有统计学意义(<0.05),但术前及术后6个月两组间差异无统计学意义(>0.05)。A组术中并发鼓索神经损伤2例(4%),B组1例(2%),差异无统计学意义(>0.05)。A组术后鼓膜一次性愈合47例(94%),B组48例(96%),差异无统计学意义(>0.05)。双人三手耳内镜下鼓室成形术与传统显微镜手术在治愈率及听力改善方面差异无统计学意义,但手术时间明显缩短,出血量少,术后恢复快。具有术野清晰、双人三手操作、微创、能到达中耳鼓窦及乳突尖范围、手术并发症少等优点,值得推广。