Jensen Dennis Friis, Hill-Madsen Louise, Holm Niels H, Ovesen Therese
Department of Otorhinolaryngology, Head and Neck Surgery University Clinic for Flavour, Balance, and Sleep, Region Hospital Gødstrup Herning Denmark.
Laryngoscope Investig Otolaryngol. 2024 Dec 2;9(6):e70037. doi: 10.1002/lio2.70037. eCollection 2024 Dec.
Our objective is to evaluate the prevalence of tympanic membrane (TM) retractions and management of signs of Eustachian tube dysfunction (ETD) in both children and adults following type 1 tympanoplasty or myringoplasty. Furthermore, to identify potential risk factors for developing ETD and TM retractions.
Retrospective cohort study of 423 patients (5-86 years of age) undergoing 452 procedures. We extracted data from electronic patient journals during scheduled consultations to calculate prevalences and relative risks. The project was reported to the Danish Data Protection Authority, and access to electronic patient journals was approved by the Institutional Board of Gødstrup Hospital.
At 1 year postoperative follow-up, the prevalence of TM retractions was 12.7% and ETD manifestations without a concurrent TM retraction was 4.2%. The graft failure rate was 11.0%. Risk factors for developing TM retractions included preoperative myringosclerosis, history of ipsilateral ear surgery, posterior perforations, and use of perichondrium graft. Conversely, previous contralateral ear surgery and temporal fascia graft use were associated with decreased risk. ETD manifestations were significantly increased in cases of preoperative bilateral perforation, history of ipsilateral ventilation tube, and traumatic TM perforation.
TM retractions accounted for 12.7%, ETD manifestations without a concurrent TM retraction 4.2%, and graft failure 11.0%. The dynamic nature of these complications necessitates diligent follow-up strategies.
Level 4.
我们的目的是评估1型鼓室成形术或鼓膜成形术后儿童和成人鼓膜（TM）内陷的发生率以及咽鼓管功能障碍（ETD）体征的处理情况。此外，确定发生ETD和TM内陷的潜在危险因素。
对423例患者（年龄5 - 86岁）进行的452例手术进行回顾性队列研究。我们在定期会诊期间从电子病历中提取数据，以计算发生率和相对风险。该项目已报告给丹麦数据保护局，访问电子病历已获得戈德斯特鲁普医院机构委员会的批准。
术后1年随访时，TM内陷的发生率为12.7%，无并发TM内陷的ETD表现为4.2%。移植失败率为11.0%。发生TM内陷的危险因素包括术前鼓膜硬化、同侧耳部手术史、后部穿孔以及使用软骨膜移植。相反，既往对侧耳部手术和使用颞肌筋膜移植与风险降低相关。术前双侧穿孔、同侧通气管置入史和外伤性TM穿孔患者的ETD表现显著增加。
TM内陷占12.7%，无并发TM内陷的ETD表现占4.2%，移植失败占11.0%。这些并发症的动态性质需要采取积极的随访策略。
4级。
