Alnosair Abdulmjeed, Binsanad Noor, Aldoseri Rashed, Nasser Mai, AlAbdulla Amal, Sivaramakrishnan Gowri, Alshehabi Mohamed
Department of Otolaryngology Head and Neck Surgery, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain.
Ministry of Health, Dammam, Kingdom of Saudi Arabia.
Indian J Otolaryngol Head Neck Surg. 2025 Jun;77(6):2363-2369. doi: 10.1007/s12070-025-05512-6. Epub 2025 May 5.
Endoscopic tympanoplasty provides superior surgical capabilities compared with microscopic technique. We aimed to investigate the surgical and functional success rates of endoscopic cartilage tympanoplasty and identify the predictors of poor outcomes. We analyzed the data for all patients who underwent endoscopic cartilage tympanoplasty at Bahrain Defence Force Royal Medical Services, Military hospital between March 2014 and April 2024. Patient demographics, clinical characteristics were analyzed. Inclusion criteria included patients with chronic otitis media and dry, stable TM perforations. Exclusions were active otitis media, perforations caused by trauma or cholesteatoma, and cases requiring mastoidectomy. Surgical success was defined as TM graft closure six months postoperatively, and functional hearing success was determined by achieving postoperative ABG ≤ 20 dB. A total of 132 patients (72 males, 60 females; mean age: 34.77 ± 16.2 years) were included. The overall surgical success rate was 81.8%, with variations across age groups. Central perforations were the most common (51.5%) and had an 81% success rates. Audiological outcomes showed significant ABG closure, with a mean pre-operative ABG of 16.34 ± 9.4 dB reducing to 9.15 ± 10.0 dB post-operatively ( < 0.001), resulting in an average ABG reduction of 7.19 ± 9.8 dB. Social hearing (ABG ≤ 20 dB) was achieved in 91% of cases. Binary logistic regression identified smoking, granulation tissue, and age < 12 years as significant predictors of graft failure. Endoscopic technique demonstrates high surgical and functional success rates. Smoking, granulation tissue, and younger age negatively impacted outcomes emphasizing the importance of patient selection in optimizing results.
与显微镜技术相比，内镜下鼓室成形术具有更卓越的手术能力。我们旨在研究内镜下软骨鼓室成形术的手术成功率和功能成功率，并确定预后不良的预测因素。我们分析了2014年3月至2024年4月期间在巴林国防军皇家医疗服务部军事医院接受内镜下软骨鼓室成形术的所有患者的数据。分析了患者的人口统计学和临床特征。纳入标准包括患有慢性中耳炎且鼓膜穿孔干燥、稳定的患者。排除标准为活动性中耳炎、由外伤或胆脂瘤引起的穿孔以及需要进行乳突切除术的病例。手术成功定义为术后六个月鼓膜移植物闭合，功能听力成功定义为术后气骨导差（ABG）≤20 dB。共纳入132例患者（72例男性，60例女性；平均年龄：34.77±16.2岁）。总体手术成功率为81.8%，各年龄组有所差异。中央穿孔最为常见（51.5%），成功率为81%。听力学结果显示气骨导差有显著改善，术前平均气骨导差为16.34±9.4 dB，术后降至9.15±10.0 dB（<0.001），气骨导差平均降低7.19±9.8 dB。91%的病例实现了社交听力（气骨导差≤20 dB）。二元逻辑回归确定吸烟、肉芽组织和年龄<12岁是移植物失败的重要预测因素。内镜技术显示出较高的手术成功率和功能成功率。吸烟、肉芽组织和较年轻的年龄对预后有负面影响，强调了患者选择对优化结果的重要性。
