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三级医疗环境下自体两片式软骨膜-软骨移植鼓室成形术的疗效

Outcomes of Tympanoplasty with an Autologous Two-Piece Perichondrium-Cartilage Graft in a Tertiary Care Setting.

作者信息

Reynders Marie, Philips Dylen, Van Den Houte Kelsey, Van Der Sypt Lynn, Levie Camille, Foulon Ina

机构信息

Department of Otorhinolaryngology and Head & Neck Surgery, University Hospital of Brussels, 2610 Brussels, Belgium.

MIPI, Vitality Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussel, Belgium.

出版信息

J Clin Med. 2025 Apr 10;14(8):2600. doi: 10.3390/jcm14082600.

Abstract

: This study evaluates the anatomical and functional outcomes of type 1 tympanoplasty using an autologous two-piece perichondrium-cartilage (CP) graft in pediatric and adult patients with tympanic membrane (TM) perforations. : A retrospective review of 74 patients (59 children, 15 adults) undergoing type 1 tympanoplasty with CP by a single surgeon (IF) was conducted. Preoperative and postoperative audiological outcomes, perforation size, prognostic factors, and complications were analyzed. Success was defined as an intact TM and an air-bone gap (ABG) < 20 dBHL at 12 months postoperatively. : TM closure was achieved in 93.2% of patients, with 93.1% attaining an ABG < 20 dBHL. The combined success rate was 86.3%, with no significant differences between children and adults. Larger perforations (>50%) had significantly lower closure rates (55.6% vs. >97%, < 0.002). Children who underwent prior adenoidectomy had significantly higher success rates ( = 0.04). : Tympanoplasty with a CP graft provides high success rates in both children and adults. The procedure can be performed from age five, considering patient cooperation. In children, simultaneous adenoidectomy is recommended if significant adenoid hypertrophy is present to optimize outcomes. Larger perforations were associated with reduced success, while age had no significant impact.

摘要

本研究评估了在患有鼓膜(TM)穿孔的儿童和成人患者中使用自体两片式软骨膜-软骨(CP)移植物进行Ⅰ型鼓室成形术的解剖学和功能结果。

对由单一外科医生(IF)进行CPⅠ型鼓室成形术的74例患者(59例儿童,15例成人)进行了回顾性研究。分析了术前和术后的听力结果、穿孔大小、预后因素及并发症。成功定义为术后12个月时TM完整且气骨导差(ABG)<20 dBHL。

93.2%的患者实现了TM封闭,93.1%的患者ABG<20 dBHL。综合成功率为86.3%,儿童和成人之间无显著差异。较大穿孔(>50%)的封闭率显著较低(55.6%对>97%,<0.002)。先前接受过腺样体切除术的儿童成功率显著更高(=0.04)。

CP移植物鼓室成形术在儿童和成人中均具有较高的成功率。考虑到患者的配合情况,该手术可从5岁开始进行。对于儿童,如果存在明显的腺样体肥大,建议同时进行腺样体切除术以优化结果。较大穿孔与成功率降低相关,而年龄无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9286/12027681/ca8a61e58d48/jcm-14-02600-g001.jpg

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