Department of Otorhinolaryngology, Wenzhou Medical University Affiliated Yiwu Hospital, Yiwu City, Zhejiang Province, China.
Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241291810. doi: 10.1177/19160216241291810.
The objective of this study was to compare the postoperative infection and graft success rates, and the hearing improvement, after endoscopic cartilage underlay myringoplasty with versus without antibiotic ointment coating.
This was a retrospective case-control study. The clinical records of patients who underwent endoscopic cartilage underlay myringoplasty and who met the selection criteria were retrieved and divided based on middle ear packing status into groups with antibiotic ointment packing (AOP group) and with no antibiotic ointment packing (no-AOP group). The operation time, postoperative infection, graft success status, and hearing improvement were compared between the 2 groups.
Patients with 166 perforations constituted the AOP group, and patients with 141 perforations comprised the no-AOP group. At 3 months postoperatively, middle ear infections had occurred in 24 (14.5%) ears in the AOP group and 4 (2.8%) ears in the no-AOP group ( < .01). At 12 months postoperatively, the graft success rate was 81.3% in the AOP group and 97.9% in the no-AOP group ( < .01). No significant group differences were observed, preoperatively ( = .657) or postoperatively ( = .578), in the air-bone gap (ABG) values or mean ABG gains ( = .758).
Middle ear packing without antibiotic ointment coating does not increase the postoperative infection rate or reduce the graft success rate after endoscopic cartilage underlay myringoplasty compared to antibiotic ointment coating. On the contrary, coating with antibiotic ointment increases the risk of postoperative infection given the complexity of middle ear manipulation.
本研究旨在比较内镜下软骨下鼓膜成形术中使用与不使用抗生素软膏覆盖物的术后感染率和移植物成功率，以及听力改善情况。
这是一项回顾性病例对照研究。检索符合选择标准并接受内镜下软骨下鼓膜成形术的患者的临床记录，并根据中耳填塞情况分为使用抗生素软膏填塞（AOP 组）和不使用抗生素软膏填塞（无 AOP 组）。比较两组的手术时间、术后感染、移植物成功状态和听力改善情况。
166 个穿孔患者构成 AOP 组，141 个穿孔患者构成无 AOP 组。术后 3 个月，AOP 组有 24 只（14.5%）耳发生中耳感染，无 AOP 组有 4 只（2.8%）耳发生中耳感染（ < .01）。术后 12 个月，AOP 组移植物成功率为 81.3%，无 AOP 组为 97.9%（ < .01）。术前（ = .657）或术后（ = .578），AOP 组和无 AOP 组的气骨导差（ABG）值或平均 ABG 增益均无显著差异（ = .758）。
与抗生素软膏覆盖相比，内镜下软骨下鼓膜成形术中不使用抗生素软膏覆盖物不会增加术后感染率或降低移植物成功率。相反，由于中耳操作复杂，抗生素软膏的覆盖会增加术后感染的风险。
