耳内镜与显微镜下鼓室成形术手术效果的比较分析

Comparative analysis of the effect of tympanoplasty under otoscope and microscope

摘要:

目的 比较耳内镜与传统显微镜下鼓室成形术的安全性和疗效。方法 回顾性分析2018年12月－2019年12月在清远市人民医院耳鼻喉科接受鼓室成形术患者的病历资料。根据手术方式将患者分为经耳内镜鼓室成形术组（耳内镜组）和经显微镜鼓室成形术组（显微镜组）。比较两组患者手术引起感音神经性耳聋的风险（骨导听阈上升）、手术对听觉的改善程度（气导听阈和气骨导差下降）和鼓膜愈合情况。结果 两组患者手术效果、术前与术后3个月听力（骨导听阈／气导听阈／气骨导差）比较，差异均无统计学意义（P > 0.05）。耳内镜组鼓膜愈合率为89.5%，显微镜组为91.7%，两组比较，差异无统计学意义（P > 0.05）。结论 不管是经耳内镜还是经显微镜鼓室成形术，均不影响骨导听阈，且均可以改善气导听阈和气骨导差。经耳内镜鼓室成形术在手术安全性、听觉的改善作用和鼓膜修复成功率等方面，均可达到与显微镜下鼓室成形术相当的效果，值得临床应用和推广。

Abstract:

Objective To compare the safety and efficacy of tympanoplasty under otoendoscopy and traditional microscope.Methods From December 2018 to December 2019, the medical records of patients underwent tympanoplasty were analyzed retrospectively. According to the operation mode, the patients were divided into two groups: tympanoplasty group (otoendoscopy group) and tympanoplasty group (microscope group). The risk of sensorineural deafness caused by operation (increase of bone conduction hearing threshold), the improvement of hearing by operation (decrease of air conduction hearing threshold and air bone conduction difference) and the healing of tympanic membrane were compared between the two groups.Results No statistically significant differences were observed between the two groups regarding surgical effect, hearing restoration before and 3 months after surgery. The average hearing improvement following surgery were similar between the two groups. ET resulted in the successful healing of 89.5% of ear drums, whereas MT led to successful healing in 91.7% of cases.Conclusion Endoscopic tympanoplasty can achieve the same effect as microscopical tympanoplasty in three aspects: safety of operation, improvement of hearing and success rate of tympanoplasty. It can increase clinical application and promotion.