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内镜经耳道软骨-软骨膜移植1型鼓室成形术:一项前瞻性研究

Endoscopic Transcanal Type 1 Tympanoplasty with Cartilage Perichondrium Graft; A Prospective Study.

作者信息

Makwana Parth, Prajapati Viral, Makadiya Vivek

机构信息

Department of ENT, Nootan Medical College, Visnagar, Gujarat, India.

Department of ENT, Dr. M. K.Shah Medical College, Ahmedabad, Gujarat, India.

出版信息

Iran J Otorhinolaryngol. 2025;37(5):261-266. doi: 10.22038/ijorl.2025.83887.3826.

Abstract

INTRODUCTION

Recently use of endoscopes for ear surgeries is being popular among the surgeons as it gives a wide view of the middle ear. Also, tympanoplasty by transcanal approach can be done as a day care procedure and so it reduces the cost of hospitalization. The study was aimed to evaluate the results of type 1 tympanoplasty done by endoscopic transcanal approach with cartilage perichondrium graft, in relation to successful graft take-up rate and improvement in hearing.

MATERIALS AND METHODS

Total 50 patients were included in the study and all of them underwent type 1 tympanoplasty by endoscopic transcanal approach. Tragal cartilage with its attached perichondrium on one side facing laterally was placed as graft lateral to handle of malleus with v shaped notch at 12 o clock by underlay technique in all the cases. Patients were called for regular follow-up, and they were observed for successful graft take-up and improvement in hearing at 3 months after procedure.

RESULTS

Out of 50 cases complete closure was achieved in 46 cases which makes a success rate of 92%. The average improvement in hearing of 15.3 dB was noted.

CONCLUSION

Endoscopic Transcanal approach with cartilage-perichondrium graft for tympanoplasty (type 1) is effective in terms of successful graft take-up rate and improvement in hearing, very cost effective, faster in terms of surgical time, and has less postoperative morbidity so gives better quality of life to the patient.

摘要

引言

近年来,内窥镜在耳部手术中的应用在外科医生中越来越普遍,因为它能提供中耳的广阔视野。此外,经耳道入路的鼓室成形术可作为日间手术进行,因此降低了住院费用。本研究旨在评估采用内窥镜经耳道入路并使用软骨-软骨膜移植物进行Ⅰ型鼓室成形术的效果,包括移植物成功植入率和听力改善情况。

材料与方法

本研究共纳入50例患者,所有患者均接受了内窥镜经耳道入路的Ⅰ型鼓室成形术。在所有病例中,均采用衬里技术,将一侧朝外附着有软骨膜的耳屏软骨放置在锤骨柄外侧,在12点位置有一个V形切口。患者被要求定期随访,并在术后3个月观察移植物是否成功植入以及听力是否改善。

结果

50例病例中,46例实现了完全封闭,成功率为92%。听力平均提高了15.3分贝。

结论

采用内窥镜经耳道入路并使用软骨-软骨膜移植物进行鼓室成形术(Ⅰ型),在移植物成功植入率和听力改善方面是有效的,成本效益非常高,手术时间更快,术后发病率更低,因此能为患者提供更好的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c1c/12451704/81506c32d804/ijo-37-261-g001.jpg

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