Gersdorff M, Garin P, Decat M, Juantegui M
Department of Otolaryngology, Catholic University of Louvain, Brussels, Belgium.
Am J Otol. 1995 Jul;16(4):532-5.
This report presents the long-term results 3 years after primary myringoplasties performed with formolized fascia temporalis autografts. The overall closure rate was 87.7% of cases, with improvement in hearing in 67.2% of cases. The best results were achieved with total perforations, and not with partial posterior perforations, contrary to popular opinion. The anterior perforations were the most difficult to close. Anterior angle blunting was avoided by careful technique. Although the results of myringoplasty are clearly better in adults than in children, there is not a determined "frontier age" before which a child may not undergo operation. The state of the middle ear at the time of operation influences surgical outcome: wet ears have a higher rate of perforation, myringitis, and retraction pocket. Medical treatment is recommended prior to surgery in every discharging ear, as a diagnostic method rather than a therapeutic one. If the ear remains wet, chronic otitis media should be considered rather than simple perforation of the eardrum, and a mastoidectomy should be combined with the myringoplasty.
本报告展示了使用甲醛固定的颞肌自体筋膜进行初次鼓膜成形术后3年的长期结果。总体闭合率为87.7%的病例，67.2%的病例听力得到改善。与普遍看法相反，完全穿孔取得的效果最佳，而非部分后穿孔。前穿孔最难闭合。通过仔细操作避免前角变钝。尽管鼓膜成形术在成人中的效果明显优于儿童，但并没有一个确定的“临界年龄”，在此年龄之前儿童不能接受手术。手术时中耳的状况会影响手术结果：耳部潮湿时穿孔、鼓膜炎症和内陷袋的发生率更高。对于每只流脓的耳朵，术前建议进行药物治疗，作为一种诊断方法而非治疗方法。如果耳朵仍然潮湿，应考虑慢性中耳炎而非单纯鼓膜穿孔，并应在鼓膜成形术的同时联合进行乳突切除术。
