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内镜鼓室成形术与软骨 vs. 颞肌筋膜在慢性化脓性中耳炎伴非活动性黏膜疾病中的比较:一项前瞻性随机研究。

Comparison of endoscopic tympanoplasty, cartilage vs. temporalis fascia in chronic suppurative otitis media with inactive mucosal disease: A prospective randomised study.

机构信息

Department of ENT, Kota medical college, Kota, Rajasthan, India.

Department of ENT, Sawai Man Singh medical college, Jaipur, Rajasthan, India.

出版信息

Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6377-6383. doi: 10.1007/s00405-024-08879-4. Epub 2024 Aug 4.

DOI:10.1007/s00405-024-08879-4
PMID:39098959
Abstract

BACKGROUND

The introduction of endoscopy into middle ear has open up new opportunities for minimal invasive temporal bone surgery. The present study was planned to compare anatomical and functional outcome in patients who underwent endoscope assisted tympanoplasty using cartilage and temporalis fascia graft.

METHODS

The present prospective observational randomized study was carried out in the Department of Otorhinolaryngology of a tertiary care teaching hospital of Rajasthan, India from September 2020 to July 2021. Fifty patients of age group 18-60 years, with diagnosis of chronic otitis media having inactive mucosal disease were enrolled in the study and divided into two groups viz. cartilage (group I) and temporalis fascia group (group II). Each patient postoperatively underwent otoscopic examination of ear and pure tone audiometery at 8 weeks and 3rd month. Local wound condition, graft uptake and healing and hearing were assessed and compared.

RESULTS

Graft uptake was 92% in cartilage group and 84% in temporalis fascia group. Air conduction and air-bone gap of patients in both the groups showed significant improvement after 3 months of surgery. (p˂0.05) Regarding bone conduction, both groups had shown non-significant changes. (p > 0.05) Hearing gain was comparable on both groups which was 6.71dB in cartilage group vs. 5.9 dB in other group.

CONCLUSIONS

The present study showed that graft placement time for temporalis fascia graft was less than cartilage graft, but the difference was insignificant. Hearing improvement, graft uptake and clinical improvement were found to be statistically insignificant between both groups.

摘要

背景

内镜技术引入中耳为微创颞骨手术开辟了新的机会。本研究旨在比较使用软骨和颞肌筋膜移植物进行内镜辅助鼓室成形术的患者的解剖学和功能结果。

方法

本前瞻性观察性随机研究于 2020 年 9 月至 2021 年 7 月在印度拉贾斯坦邦的一家三级护理教学医院的耳鼻喉科进行。共有 50 名年龄在 18-60 岁之间、患有慢性中耳炎且无活动性黏膜疾病的患者入组,并分为两组,即软骨组(I 组)和颞肌筋膜组(II 组)。每位患者术后 8 周和 3 个月进行耳部耳镜检查和纯音测听。评估和比较局部伤口状况、移植物吸收和愈合以及听力。

结果

软骨组的移植物吸收率为 92%,颞肌筋膜组为 84%。两组患者术后 3 个月气导和气骨间隙均有显著改善。(p<0.05)关于骨导,两组均无明显变化。(p>0.05)两组患者的听力增益均相当,软骨组为 6.71dB,另一组为 5.9dB。

结论

本研究表明,颞肌筋膜移植物的放置时间比软骨移植物短,但差异无统计学意义。听力改善、移植物吸收率和临床改善在两组之间无统计学差异。

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