耳内镜下嵌入蝶形软骨鼓膜成形术治疗鼓膜前缘穿孔效果及对患者听力恢复的影响

目的研究耳内镜下嵌入蝶形软骨鼓膜成形术治疗鼓膜前缘穿孔效果及对患者听力恢复的影响。方法回顾性分析2017年11月至2019年11月宣城市人民医院进行鼓膜前缘穿孔治疗的100例患者资料,依据患者的治疗方式不同,将其分为观察组与对照组,每组各50例。观察组行耳内镜下嵌入蝶形软骨鼓膜成形术,对照组行显微镜下颞肌筋膜修补术。比较2组患者手术相关指标、鼓膜穿孔愈合率以及并发症发生以及治疗前后的气导挺阈值。结果对照组与观察组的手术时间分别为(85.17±16.14)、(44.67±11.04)min,对照组与观察组的出血量分别为(13.44±1.37)、(6.37±1.36)mL,观察组的手术时间与术中出血量均显著少于对照组,差异有统计学意义(P<0.05)。观察组的鼓膜穿孔愈合率96.00%显著高于对照组的82.00%,差异有统计学意义(P<0.05)。观察组的鼓膜内陷、移植物感染的发生率为0.00%、2.00%,显著低于对照组(8.00%、14.00%),差异有统计学意义(P<0.05)。治疗后观察组、对照组患者气导挺阈值分别为(41.56±4.52)、(41.36±4.53)dB,显著高于治疗前(28.37±4.62)、(27.28±4.26)dB],差异有统计学意义(P<0.05),2组患者治疗前与治疗后组间气导挺阈值比较,差异均无统计学意义(P>0.05)。结论应用耳内镜下嵌入蝶形软骨鼓膜成形术治疗鼓膜前缘穿孔具有手术时间短、出血量少、鼓膜穿孔愈合率高、并发症少的优点,并且其听力恢复效果与显微镜下颞肌筋膜修补术相比无明显差异,该方法在临床上值得推广。

Effect of endoscopic tympanoplasty with sphenoid cartilage in the treatment of perforation of anterior tympanic membrane and its influence on hearing recovery

Objective To study the effect of endoscopic tympanoplasty with sphenoid cartilage in the treatment of perforation of anterior tympanic membrane and its influence on hearing recovery.Methods A retrospective analysis of 100 patients with perforation of anterior tympanic membrane in Xuancheng People's Hospital from November 2017 to November 2019 was conducted.According to different treatment methods,100 patients were divided into observation group and control group,with 50 patients in each group.The observation group was treated with myringoplasty embedded with butterfly cartilage under otoscope,and the control group was treated with temporalis myofascial repair under microscope Standard,healing rate of tympanic membrane perforation,occurrence of complications and air conduction threshold before and after treatment.Results The operation time of the control group and the observation group were(85.17±16.14)min and(44.67±11.04)min.The blood loss of the control group and the observation group were(13.44±1.37)mL and(6.37±1.36)mL,respectively.The operation time and intraoperative blood loss of the observation group were significantly less than those of the control group,and the difference was statistically significant(P<0.05).The healing rate of tympanic membrane perforation in the observation group was 96.00%,which was significantly higher than that in the control group(82.00%),the difference was statistically significant(P<0.05).The incidence of tympanic membrane and graft infection in the observation group was 0.00% and 2.00%,which were significantly lower than those in the control group(8.00%,14.00%),and the difference was statistically significant(P<0.05).After treatment,the air conduction stiffness thresholds of the observation group and the control group were(41.56±4.52)dB and(41.36±4.53)dB,which were significantly higher than those before treatment(28.37±4.62)dB,(27.28±4.26)dB],and the difference was statistically significant It is of scientific significance(P<0.05).There was no significant difference in air conduction stiffness threshold between the two groups before and after treatment(P>0.05).Conclusion It has the advantages of short operation time,less blood loss,high healing rate and fewer complications in the treatment of anterior tympanic membrane perforation with butterfly cartilage myringoplasty under otoendoscopy.Moreover,the hearing recovery effect is not significantly different from that of the repair of temporal muscle fascia under microscope.This method is worthy of promotion in clinical practice.