Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
Department of Otorhinolaryngology-Head and Neck Surgery, The 928th Hospital of PLA Joint Logistics Support Force, Haikou, China.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241267724. doi: 10.1177/19160216241267724.
This study aimed to explore the impacts of different middle-ear mucosal conditions on the outcomes of type I tympanoplasty.
A retrospective analysis of 164 patients with chronic otitis media was carried out. The patients were divided into 4 groups according to their mucosal condition. Preoperative hearing levels and air-bone gap (ABG) before and after surgery were compared via the Kruskal‒Wallis test. The chi-squared test and Fisher's exact test were used to assess the postoperative complications and impact factors of functional success.
Preoperatively, neither the air conduction nor bone conduction values differed significantly among groups with different mucosal conditions. All of the ABG closed dramatically after type I tympanoplasty ( < .05) regardless of the mucosal conditions. The functional success rates were lower when the intratympanic mucosa was moderately or severely edematous compared with mildly edematous or normal ( < .05). The disease course, perforation site, and perforation size, as well as the status of the opposite ear, were not related to the auditory functional outcome. The differences in postoperative reotorrhea and reperforation among the 4 groups were not statistically significant.
Preoperative hearing levels were not affected by middle-ear mucosal conditions. The functional success rate was influenced by mucosal conditions, but hearing levels were significantly enhanced after surgical intervention regardless of the mucosal status. Postoperative complications were not related to the mucosal conditions. Thus, type I tympanoplasty is adoptable for mucosal abnormalities when pharmacotherapy cannot result in a healthy tympanum.
本研究旨在探讨不同中耳黏膜状况对 I 型鼓室成形术效果的影响。
对 164 例慢性中耳炎患者进行回顾性分析。根据黏膜状况将患者分为 4 组。采用 Kruskal-Wallis 检验比较术前和术后听力水平及气骨导差（ABG）。采用卡方检验和 Fisher 确切概率法评估术后并发症和功能成功的影响因素。
术前，不同黏膜状况组的气导值和骨导值均无显著差异。I 型鼓室成形术后所有 ABG 均显著缩小（ < .05），与黏膜状况无关。与轻度水肿或正常相比，鼓室内黏膜中度或重度水肿时功能成功率较低（ < .05）。病程、穿孔部位和穿孔大小以及对侧耳状态与听力功能结果无关。4 组间术后再发耳漏和再穿孔的差异无统计学意义。
术前听力水平不受中耳黏膜状况影响。功能成功率受黏膜状况影响，但无论黏膜状况如何，手术干预后听力水平均显著提高。术后并发症与黏膜状况无关。因此，当药物治疗不能使鼓膜保持健康时，可采用 I 型鼓室成形术治疗黏膜异常。
