Soni Samanvaya, Soni Ankita, Sahay Neeti, Sharma Man Prakash, Modwal Amit
National Institute of Medical Sciences and Research, Jaipur, Rajasthan India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4261-4264. doi: 10.1007/s12070-024-04831-4. Epub 2024 Jun 27.
Since 1952, myringoplasty has evolved with various surgical techniques, including overlay, underlay, sandwich, pegging, rosette, and plugging. Overlay and underlay methods are most commonly used. In 1998, Eavey introduced the cartilage and perichondrium butterfly inlay myringoplasty, designed for small to medium-sized perforation closure, offering practical advantages such as reduced surgical time and improved hearing outcomes. A one-year prospective study (September 2022 to September 2023) in a tertiary care hospital in India involved 30 patients aged 9-52 years with inactive small central perforations. Pre-operative pure tone audiometry (PTA) results were required to be no higher than 35 dB conductive hearing loss. General or local anesthesia was used based on the patient's age. The surgical technique involved visualizing the perforation, graft preparation, and transcanal insertion. Among the 30 patients, the graft uptake rate was 100% at 3 months and 93.33% at 6 months. Pre-operative mean PTA was 29.76 dB, which decreased to 25.03 dB post-operatively, with a statistically significant air-bone gap closure of 4.73 dB. Cartilage rosette inlay-onlay myringoplasty offers an effective solution for small to medium-sized perforations, achieving high success rates (93.33%). This technique is associated with reduced surgical time, suitability for day care surgery, and minimal scarring, making it a valuable addition to routine clinical practice.
The online version contains supplementary material available at 10.1007/s12070-024-04831-4.
自1952年以来,鼓膜成形术已随着各种手术技术的发展而演变,包括覆盖法、衬里法、三明治法、栓钉法、花环法和填塞法。覆盖法和衬里法是最常用的方法。1998年,伊维引入了软骨和软骨膜蝴蝶镶嵌鼓膜成形术,该方法专为中小型穿孔闭合设计,具有减少手术时间和改善听力结果等实际优势。在印度一家三级护理医院进行的一项为期一年的前瞻性研究(2022年9月至2023年9月)涉及30名年龄在9至52岁之间、中央小穿孔处于静止期的患者。术前纯音听力测定(PTA)结果要求传导性听力损失不高于35分贝。根据患者年龄使用全身麻醉或局部麻醉。手术技术包括观察穿孔、制备移植物和经耳道插入。在这30名患者中,移植物摄取率在3个月时为100%,在6个月时为93.33%。术前平均PTA为29.76分贝,术后降至25.03分贝,气骨导差闭合4.73分贝,具有统计学意义。软骨花环镶嵌-覆盖鼓膜成形术为中小型穿孔提供了一种有效的解决方案,成功率很高(93.33%)。该技术与缩短手术时间、适合日间手术以及疤痕最小化相关,使其成为常规临床实践中有价值的补充。
在线版本包含可在10.1007/s12070-024-04831-4获取的补充材料。