Pulec J L, Reams C L
Otolaryngol Clin North Am. 1977 Oct;10(3):553-61.
The use of a homograft tympanic membrane with and without attached ossicles, staging the operation, and the use of sculptured homograft or autograft ossicles have improved the results in tympanoplasty. The indications and techniques of homograft tympanoplasty are described, and the results in 99 primary cases and 11 cases with repair of a mastoid cavity are given. The overall graft success rate was 86 per cent. In patients with an intact ossicular chain, the conductive loss was reduced to less than 20 dB. in 88 per cent. A hearing loss less than 20 dB. was obtained in 68 per cent with an intact stapes, in 77 per cent when the stapes superstructure was absent, and in 79 per cent in stapedectomy done at a second stage. The use of homograft material has provided the means for significantly improving the results in our patients who require tympanoplasty.
使用带或不带附着听小骨的同种异体鼓膜、分阶段进行手术以及使用雕刻的同种异体或自体听小骨，已改善了鼓室成形术的效果。本文描述了同种异体鼓室成形术的适应证和技术，并给出了99例原发性病例和11例乳突腔修复病例的结果。总体移植成功率为86%。在听骨链完整的患者中，88%的患者传导性听力损失降低至20分贝以下。镫骨完整时，68%的患者听力损失小于20分贝；镫骨上部结构缺失时，77%的患者听力损失小于20分贝；二期进行镫骨切除术时，79%的患者听力损失小于20分贝。使用同种异体材料为显著改善我们需要鼓室成形术的患者的手术效果提供了方法。
