Perkins R, Bui H T
California Ear Institute at Stanford, Palo Alto, CA 94304, USA.
Otolaryngol Head Neck Surg. 1996 Mar;114(3):366-79. doi: 10.1016/s0194-5998(96)70205-x.
This study describes 20 years' experience with autogenous temporalis fascia that is formed and shaped by formaldehyde cross-linking with special Fasciaform (Hear America, Palo Alto, Calif.) molds in the repair of large tympanic membrane perforations. One hundred twenty operations in 113 patients were performed between 1973 and 1993 to close large perforations in patients with intact ossicular chains. All perforations were successfully closed by this technique. Audiometric studies indicated that the postoperative air-borne gap was closed to within 0 to 10 dB in 63% and to within 0 to 20 dB in 97%. One patient had a 15-dB sensorineural hearing impairment. Graft lateralization requiring revision occurred in three patients, two of whom had previous unsuccessful tympanoplasties. Comparisons of adult vs. pediatric groups and primary vs. revision groups were made. The technique ensures the removal of any ectopic epithelium on the medial surface of the tympanic membrane remnant and provides for easy graft placement and stability during healing without the use of middle ear Gelfoam (Upjohn Co., Kalamazoo, Mich.). The formaldehyde-formed fascia graft or Fasciaform graft technique provides an effective method of closing large perforations with excellent functional results and minimal complications.
本研究描述了使用经甲醛交联并通过特殊的Fasciaform（美国加利福尼亚州帕洛阿尔托市的Hear America公司）模具塑形的自体颞肌筋膜修复大鼓膜穿孔20年的经验。1973年至1993年间，对113例患者进行了120次手术，以闭合听骨链完整患者的大穿孔。所有穿孔均通过该技术成功闭合。听力测定研究表明，术后气导间隙在63%的患者中缩小至0至10 dB以内，在97%的患者中缩小至0至20 dB以内。1例患者有15 dB的感音神经性听力损害。3例患者出现移植物侧方移位需要翻修，其中2例此前鼓膜成形术失败。对成人组与儿童组以及初次手术组与翻修手术组进行了比较。该技术可确保去除鼓膜残余物内表面的任何异位上皮，并且在愈合过程中无需使用中耳明胶海绵（美国密歇根州卡拉马祖市的Upjohn公司生产）即可轻松放置移植物并保持其稳定性。经甲醛形成的筋膜移植物或Fasciaform移植物技术提供了一种闭合大穿孔的有效方法，功能效果极佳且并发症极少。
