耳内镜下鼓膜修补术后穿孔再修补的疗效分析

Analysis of curative effect of re-repair of perforation after tympanic membrane repair under ear endoscope

摘要:

目的 探讨人工硬脑膜和表皮生长因子在耳内镜下鼓膜修补术后鼓膜穿孔再修补中的临床疗效。方法 选择该院耳内镜下鼓膜修补术后复查时仍有鼓膜穿孔未愈合的患者58例，随机分为A组和B组，各29例。A组采用明胶海绵修补鼓膜穿孔，B组采用人工硬脑膜和表皮生长因子修补鼓膜穿孔，每个月复查鼓膜愈合情况，3个月后复查纯间测听。结果 A组修补成功率为34.48%（10/29），B组修补成功率为75.86%（22/29），两组患者比较，差异有统计学意义（P < 0.05）；A组气骨导差改善（7.32±2.68）dB HL，B组气骨导差改善（21.77±4.65）dB HL，两组患者比较，差异有统计学意义（P < 0.05）。结论 人工硬脑膜是合适的鼓膜再生支架，表皮生长因子可促进鼓膜穿孔愈合，两者结合使用是鼓膜再修补的一种可行的治疗方案。

Abstract:

Objective To investigate the clinical efficacy of artificial dura mater and epidermal growth factor in the repair of tympanic membrane perforation after endoscopic tympanic membrane repair.Methods 58 patients with tympanic membrane perforation were randomly divided into two groups, 29 cases in each. Group A was repaired with gelatin sponge, group B was repaired with artificial dura mater and epidermal growth factor. The tympanic membrane healing was reviewed every month, and the pure tone audiometry was reviewed after 3 months.Results The success rate of repair in group A was 34.48% (10/29), and that in group B was 75.86% (22/29). The difference was statistically significant (P < 0.05). The air-bone gap in group A was improved by (7.32 ± 2.68) dB HL, and that in group B was improved by (21.77 ± 4.65) dB HL. The difference was statistically significant (P < 0.05 ).Conclusion Artificial dura mater is a suitable tympanic membrane regeneration scaffold. Epidermal growth factor can promote the healing of tympanic membrane perforation. The combination of the two is a feasible treatment for tympanic membrane repair.