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我们在内镜下纽扣式鼓膜成形术治疗不同大小鼓膜穿孔方面的经验:病例系列研究

Our Experience in Endoscopic Button Tympanoplasty Providing High Success Rate in Varying Sizes of Perforation : A Case Series.

作者信息

Bali Kulbhushan, Das Deepthy

机构信息

Department of ENT and Head & Neck Surgery, Sri Madhusudan Sai Institute of Medical Sciences and Research, Muddenahalli, Chikkaballapur, Karnataka 562101 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4550-4553. doi: 10.1007/s12070-024-04914-2. Epub 2024 Jul 25.

Abstract

Cartilage tympanoplasty is a fast growing technique used to restore hearing in chronic suppurative otitis media. The technique has misnomers such as limited applicability in only small size perforations, interference with sound conducting mechanism and durability. Our experience in out tertiary care Institution with over 100 retrospective study cases prove that there is a scope of proving it to be well established technique. That could be used in par with other tympanoplasty techniques. Our retrospective case series of 100 operated between 2021 and 2024 were taken, having unilateral perforation convenience data collection purpose. The overall success rates of cartilage / button tympanoplasty of varying perforation sizes, having a wide range of pure tone audiometry statuses having successful results were discussed, which is indicated as a percentage format. In our retrospective case series, out of our 100 cases we had 90 successful graft uptake cases. The 10% cases were later followed up in our study. It was analysed and concluded that the technique was not the inhibiting factor but the post operative care had prevented the patients from having the desired results. Our results are in accordance with previous case studies for support. Pure tone audiometry were taken pre operatively and post operatively that support cartilage / button tympanoplasty. Cartilage tympanoplasty is a commonly misunderstood technique which if corrected has a wide scope to be used a s a common treatment modality. Data collected and inference were in concordance with previous studies conducted. Tragal cartilage due to its durability, low inflammatory reaction to tympanic membrane, lesser chances of retraction and long term assurance of withstanding environmental conditions has proven to be technique which can be used in regular basis. Cartilage / button tympanoplasty is a technique that has a shorter learning curve for surgeons. With a high demand of cases in chronic suppurative otitis media-Tubotympanic type, button tympanoplasty technique is an assest.

摘要

软骨鼓膜成形术是一种快速发展的用于恢复慢性化脓性中耳炎听力的技术。该技术存在一些误称,如仅适用于小尺寸穿孔、干扰声音传导机制和耐久性等问题。我们在三级医疗机构进行的100多例回顾性研究病例的经验证明,有证据表明它可以成为一种成熟的技术。它可以与其他鼓膜成形术技术相媲美。我们选取了2021年至2024年间接受手术的100例回顾性病例系列,为方便数据收集,均为单侧穿孔。讨论了不同穿孔大小、具有广泛纯音听力测定状态且手术成功的软骨/纽扣鼓膜成形术的总体成功率,以百分比形式表示。在我们的回顾性病例系列中,100例中有90例移植成功。10%的病例在我们的研究中进行了后续随访。分析得出结论,技术并非抑制因素,而是术后护理妨碍了患者获得理想结果。我们的结果与之前的病例研究一致,可作为支持。术前和术后均进行了纯音听力测定,以支持软骨/纽扣鼓膜成形术。软骨鼓膜成形术是一种常被误解的技术,如果纠正过来,有广泛的应用范围,可作为一种常见的治疗方式。收集的数据和推断与之前进行的研究一致。由于其耐久性、对鼓膜的低炎症反应、回缩机会较少以及长期耐受环境条件的保证,耳屏软骨已被证明是一种可常规使用的技术。软骨/纽扣鼓膜成形术对外科医生来说学习曲线较短。鉴于慢性化脓性中耳炎-咽鼓管鼓室型病例需求高,纽扣鼓膜成形术是一项资产。

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