基层医院开展耳内镜下鼓膜成形术54耳的临床研究

Clinical study of endotoscopic myringoplasty in primary hospital:a report of 54 cases

摘要:

目的 探讨基层医院应用耳内镜技术开展鼓膜穿孔修补术的临床研究。 方法 在耳内镜下采用不同材料对鼓膜穿孔的54耳患者进行修补手术，并针对穿孔的大小和部位采用不同方法处理。 结果 随访3～6个月，平均3.4个月。鼓膜穿孔总愈合率为88.9%，其中脂肪92.3%、颞肌筋膜90%、软骨膜88.46%、软骨膜-软骨80%。比较差异无显著性（χ2=0.646，P >0.05），54耳的术前听力学检查均有不同程度的传导性听力下降，术后平均气导提高>10 dB者有38耳（70.4%）。 结论 基层医院开展耳内镜下鼓膜穿孔修补手术均能达到有效的治疗结果，适合推广应用，但移植材料要根据鼓膜穿孔大小和类型的不同合理选择。

Abstract:

【Objective】 To explore the clinical application of endotoscope in repairing the perforation of tympanic membrane in primary hospital. 【Methods】 We analyzed the data from 54 patients operated on for a tympanic perforation using endotoscope with different graft. 【Results】 Patients were followed up postoperatively for 3~6 months. The average closure rate of tympanic membrane perforations was 88.9% (92.3% in fat group, 90% in temporal fascia group, 88.46% in perichondrium group and 80% in perichondrial cartilage group). The improvement in pure tone air conduction threshold more than 10 dBHL was achieved in 38 cases after operation, the difference was statistically significant (P <0.05). 【Conclusion】 Endotoscopic myringoplasty is a rapid, safe, reliable and efficient procedure that should be performed in primary hospital. Different graft material should be chosen reasonably according to different size and type of the tympanic membrane perforation.