Albera R, Ferrero V, Canale G
II Clinica ORL, Università di Torino.
Acta Otorhinolaryngol Ital. 1997 Feb;17(1):15-21.
Myringoplasty has been increasingly refined in recent years and today the most frequently employed are the "overlay", the "underlay" and the "interlay". Of these the overlay technique appears to best guarantee graft stability. However, with this technique there is the risk of blunting and neotympanum lateralization which can compromise functional recovery. To obviate these drawbacks, the authors propose a modification of the classical overlay technique. This modification consists of detachment of the anterior portion of the Gerlach annulus and the adjacent protympanum mucosa in order to insert the graft between the bony and fibrous portions of the annulus. This technique is defined as the "Annular Wedge Tympanoplasty" (AWT). From January 1993 to July 1994 a total of 74 tympanoplasties were performed using the AWT technique to reconstruct the tympanic membrane. In 71 (96%) of these, the opening closed completely. As regards incomplete healing, 2 cases showed signs of blunting, 3 showed posterior lateralization and 1 full lateralization with a reduction in the hearing level recovery. The work is not conclusive although it does present a technique which is easy to perform and which provides good functional recovery.
近年来，鼓膜成形术已日益完善，如今最常用的方法是“覆盖法”“夹层法”和“内植法”。其中，覆盖法似乎最能确保移植物的稳定性。然而，采用这种方法存在使鼓室变钝和新鼓膜侧移的风险，这可能会影响功能恢复。为了避免这些缺点，作者提出了对经典覆盖法的一种改良。这种改良包括分离格拉赫环的前部和相邻的鼓室前壁黏膜，以便将移植物插入环的骨质部分和纤维部分之间。这种技术被定义为“环形楔形鼓膜成形术”（AWT）。从1993年1月至1994年7月，共采用AWT技术进行了74例鼓膜成形术以重建鼓膜。其中71例（96%）穿孔完全闭合。至于愈合不完全的情况，2例出现鼓室变钝迹象，3例出现后外侧移位，1例完全侧移且听力水平恢复降低。这项研究尚无定论，尽管它确实提出了一种易于实施且能实现良好功能恢复的技术。
