初次与再次Ⅰ型鼓室成形术疗效分析

The Comparison of the Curative Effect between Primary and Revision TypeⅠTympanoplasties

康尧杰;张路;

1:湖北省恩施自治州中心医院耳鼻咽喉头颈外科

摘要

目的比较初次与再次Ⅰ型鼓室成形术后鼓膜愈合率和听力疗效。方法回顾性分析2016年1月～2018年12月期间初次Ⅰ型鼓室成形术的64例(64耳)和再次手术的70例(70耳)鼓膜穿孔患者的临床资料,对两组患者术后6个月时的鼓膜愈合率和听力情况进行对比。结果初次手术组鼓膜愈合率为96.9%(62/64),再次手术组为78.6%(55/70),前者高于后者,差异有统计学意义(P<0.01);初次和再次手术组鼓膜修复成功者术后气骨导差(ABG)≤30 dB者分别为93.5%(58/62)和90.9%(50/55)(P>0.05),术后气骨导差(ABG)≤20 dB者分别为83.9%(52/62)和76.4%(42/55)(P>0.05)。结论初次手术组术后鼓膜愈合率明显高于再次手术组,但两组鼓膜修复成功者术后听力提高的疗效相当。

关键词

鼓膜愈合率;听力疗效;Ⅰ型鼓室成形术;鼓膜穿孔

基金项目(Foundation):

作者

康尧杰;张路;

参考文献

1 Oanl K,Uguz MZ,Kazikdas KC,et al.A multivariate analysis of otological,surgical and patient related factors indetermining success in myingoplasty[J].Clin Otolaryngol,2005,30:115.

2 Pinar E,Sadullahoglu K,Calli C,et al.Evaluation of prognostifactors and middle ear risk index In tympanoplasty[J].Otolaryngol Head Neck Surg,2008,139:386.

3 Nadol JB,Staecker H,Gliklich RE.Outcomes assessment for chronic otitis media:the chronic ear survey[J].The Laryngoscope,2000,110:32.

4 Andersen SA,Aabenhus K,Glad H,et al.Graft take-rates after tympanoplasty:results from a pros- pective ear surgery database[J].Otology & Neurotology,2014,35:292.

5 Fukuchi I,Cerchiari DP,Garcia E,et al.Tympanoplasty:surgical results and a comparison of the factors that may interfere in their success[J].Revista Brasileira de Otorrinolaringologia,2006,72:267.

6 李鹏,李永奇,黄健聪,等.耳内镜下自体脂肪鼓膜修补术的临床应用分析[J].临床耳鼻咽喉头颈外科杂志,2008,22:1045.

7 Hardman J,Muzaffar J,Nankivell P,et al.Tympanoplasty for chronic tympanic membrane perfora- tion in children:systematic review and meta-analysis[J].Otology & Neurotology,2015,36:796.

8 Westerberg J,Harder H,Magnuson B,et al.Ten-year myringoplasty series:does the cause of perfora-tion affect the success rate [J]?The Journal of Laryngology and Otology,2011,125:126.

9 Balaguer RG,Morales MS,Tamarit JC,et al.Myringoplasties.A retrospective analysis of our surgical outcomes[J].Acta Otorrinolaringologica Espanola,2011,62:213.

10 Veldman JE,Braunius WW.Revision surgery for chronic otitis media:a learning experience.Report on 389 cases with a long-term follow-up[J].Annals of Otology Rhinology & Laryngology,1998,107:486.

11 Vartiainen E.Findings in revision myringoplasty[J].Ear,Nose,& Throat Journal,1993,72:201.

12 李荟元.血液供应与病理性瘢痕发生的关系[J].中国美容医学,2005,14:526.

13 Chang CY,Gray LC.Pressed scar tissue for tympanic membrane grafting in revision tympanoplasty[J].Otolaryngol Head Neck Surg,2005,132:30.

14 Landsberg R,Fishman G,DeRowe A,et al.Fat graft myringoplasty:results of a long term follow-up [J].Journal of Otolaryngology,2006,35:44.

15 李惠,杨霞,陆玲,等.再次Ⅰ型鼓室成形术经验分析[J].临床耳鼻咽喉头颈外科杂志,2018,32:1703.

16 朱文燕,马永驰,金新,等.鼓膜修补术联合咽鼓管球囊扩张治疗鼓膜穿孔的疗效观察[J].中国中西医结合耳鼻咽喉科杂志,2017,25:247.

17 李慧林,张志飞,王武庆.不同状态的慢性化脓性中耳炎施行鼓膜成形术的回顾性分析[J].临床耳鼻咽喉头颈外科杂志,2017,31:1473.

18 Djalilian HR.Revision tympanoplasty using scar tissue graft[J].Otology & Neurotology,2006,27:131.

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康尧杰张路