鼓膜残片上皮炎症对鼓室成形术预后的影响
The Impact of Epithelial Inflammation in Membrane Remnants on the Outcome of Tympanoplasty.
作者信息
Galindo-Tapia María Fernanda, Deras-Quiñones Alejandro Esteban, Montoya-Fuentes Itzel Maria, Madrigal-Santillán Eduardo Osiris, Morales-González Ángel, Flores-Fuentes Naria A, Anguiano-Robledo Liliana, Rojas-Martínez Raúl, Montaño-Velázquez Beatriz, Morales-González José A
机构信息
Instituto Mexicano del Seguro Social, Centro Médico Nacional la Raza, Hospital General "Dr. Gaudencio González Garza", Servicio de Otorrinolaringología, Mexico City 02990, Mexico.
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Servicio de Patología, Mexico City 02990, Mexico.
出版信息
Med Sci (Basel). 2025 Jun 7;13(2):73. doi: 10.3390/medsci13020073.
BACKGROUND
Chronic otitis media (COM) with tympanic perforation sometimes requires tympanoplasty. Many factors can interfere with surgical success; however, the histological status of the remaining epithelium of the perforation has not been studied as a risk factor for surgical failure.
METHODS
This was an observational, longitudinal, and analytical study in patients with COM, candidates for tympanoplasty who met the inclusion criteria, between August and December 2024. Tympanoplasty was performed, and the tympanic ring epithelium was sent for histological analysis. After 30 days, closure or non-closure of the perforation was determined, and the results were collected. Descriptive and analytical statistics were performed according to data distribution using the SPSS 26.0 statistical package.
RESULTS
Twenty subjects were included, 80% with tubal dysfunction, 60% with central perforation, and 65% with medium-sized. In total, 13 were successful, and 7 failed. Histopathological analysis revealed dystrophic calcification, chronic lymphocytic infiltrate, histiocytic infiltrate, fibrosis, loose keratin sheets, metaplasia, and spongiosis. The logistic regression model showed an OR of 7.3 for marginal perforation and 3.4 for the OPSS score. Of the patients with surgical failure, 57.4% had epithelial inflammation.
CONCLUSIONS
epithelial inflammation affected surgical success in more than 50%.
背景
伴有鼓膜穿孔的慢性中耳炎（COM）有时需要进行鼓室成形术。许多因素会干扰手术成功；然而，穿孔处剩余上皮的组织学状态尚未作为手术失败的危险因素进行研究。
方法
这是一项针对2024年8月至12月期间符合纳入标准的COM患者（鼓室成形术候选人）的观察性、纵向分析研究。进行鼓室成形术，并将鼓膜环上皮送去进行组织学分析。30天后，确定穿孔是否闭合，并收集结果。使用SPSS 26.0统计软件包根据数据分布进行描述性和分析性统计。
结果
纳入20名受试者，80%有咽鼓管功能障碍，60%有中央穿孔，65%为中等大小穿孔。总共13例成功，7例失败。组织病理学分析显示营养不良性钙化、慢性淋巴细胞浸润、组织细胞浸润、纤维化、松散的角质层、化生和海绵形成。逻辑回归模型显示边缘穿孔的比值比为7.3，OPSS评分的比值比为3.4。手术失败的患者中，57.4%有上皮炎症。
结论
上皮炎症影响了超过50%的手术成功率。
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