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目的:探讨用耳屏软骨环 软骨膜在开放式鼓室成形术中的应用及其治疗的远期效果。方法:用耳 屏软骨环 软骨膜对38例慢性化脓性中耳炎患者行开放式鼓室成形术,并于术后2周,1、3、6个月,1、3年进行追 踪观察。结果:术后2周时,Ⅰ期愈合34例,鼓膜前下方出现裂隙2例,中耳感染2例,再次手术治愈,追踪观察 3年成功率100%;3～6个月时所有移植的新鼓膜形态完整,6个月～3年有2例鼓膜出现萎缩斑。听力情况:术 前平均气导为(45.66±8.40)dBHL,骨气导差距为(26.05±8.15)dBHL;术后1个月分别为(31.58±7.45)dB HL和(19.61±6.41)dBHL;3个月分别为(26.18±7.02)dBHL和(12.63±7.59)dBHL;6个月为(23.55± 7.70)dBHL和(10.79±5.52)dBHL。术后听力1个月较术前显著提高,术后3个月较术后1个月显著提高(均 P<0.01);但术后6个月,1、3年与术后3个月比差异无统计学意义(均P>0.05)。结论:采用耳屏软骨环 软骨 膜行鼓室成形术,取材方便,手术操作便利;修复移植的新鼓膜形态接近正常,保持了听力的稳定、持久,是理想的 移植材料,对提高鼓室成形术的质量及成功率具有重要意义。
Objective: To explore the application of tragus cartilage perichondrium in open tympanoplasty and its long-term therapeutic effect. Methods: 38 cases of chronic suppurative otitis media were undergone open tympanoplasty with tragus cartilage perichondrium, and were followed up at 2 weeks, 1, 3, 6 months and 1, 3 years after operation. Results: At 2 weeks after operation, 34 cases were healed in stage Ⅰ, 2 cases were found in front of tympanic membrane, 2 cases were middle ear infection, and the others were cured by operation. The success rate of 3 years follow-up was 100% New tympanic membrane integrity, 6 months to 3 years there are 2 cases of tympanic membrane shrinkage spot. The average preoperative air conduction was (45.66 ± 8.40) dBHL and the difference of air conduction was (26.05 ± 8.15) dBHL. The preoperative average air conduction was (31.58 ± 7.45) dB HL and (19.61 ± 6.41) dBHL, respectively (26.18 ± 7.02) dBHL and (12.63 ± 7.59) dBHL respectively in months and (23.55 ± 7.70) dBHL and (10.79 ± 5.52) dBHL in 6 months. The hearing of one month after operation was significantly increased compared with that before operation, and significantly increased after one month and three months after operation (all P <0.01). However, at 6 months, 1 and 3 years after operation and 3 months after operation The difference was not statistically significant (all P> 0.05). CONCLUSIONS: Trabeculectomy with tragus cartilage perichondrial perforation is convenient and easy to draw. Surgical operation is convenient. The morphology of new tympanic membrane is close to normal and the hearing is stable and durable. It is an ideal graft material for improving tympanoplasty Quality and success rate is of great importance.