山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (6): 69-72.doi: 10.6040/j.issn.1673-3770.0.2018.203

• 论著 • 上一篇    下一篇

耳内镜下耳屏软骨环-软骨膜修补术治疗鼓膜穿孔40例

周庆,刘雄光,吴昌林,叶小武   

  1. 北海市人民医院耳鼻咽喉科, 广西 北海 536000
  • 发布日期:2018-11-29
  • 作者简介:周庆. E-mail:zyy062510@126.com

Clinical observation of 40 cases of tympanic membrane perforation treated with auricular endoscopic cartilage ring and cartilage membrane repair

ZHOU Qing, LIU Xiongguang, WU Changlin, YE Xiaowu   

  1. Department of Otolaryngology, Beihai Peoples Hospital, Beihai 536000, Guangxi, China
  • Published:2018-11-29

摘要: 目的 探讨耳内镜下耳屏软骨环-软骨膜修补术治疗鼓膜穿孔的疗效。 方法 将80例(80耳)鼓膜穿孔患者按随机数字表法随机分为观察组与对照组各40例,观察组行耳内镜下耳屏软骨环-软骨膜修补术,对照组行显微镜下颞肌筋膜鼓膜修补术。对比两组手术时间、术中出血量、临床疗效、鼓膜愈合率、听力恢复情况及术后并发症发生率。 结果 观察组与对照组手术时间分别为(42.19±12.35)、(82.67±11.16)min,术中出血量分别为(5.06±1.34)、(14.27±2.35)mL,两组手术时间及术中出血量比较,P均<0.05。观察组治愈28例,有效10例,无效2例,总有效率为95.00%(38/40),对照组分别为23、8、9例,77.50%(31/40),两组总有效率比较,P<0.05。观察组与对照组术后1个月鼓膜愈合率分别为95.00%(38/40)、87.50%(35/40),术后6个月鼓膜愈合率分别为92.50%(37/40)、85.00%(34/40),术后12个月鼓膜愈合率分别为92.50%(37/40)、85.00%(34/40),两组术后1、6、12个月鼓膜愈合率比较,P均>0.05。两组术后1、6、12个月听力恢复情况比较差异无统计学意义(P均>0.05)。观察组术后1年内发生再度穿孔3例(7.5%),对照组术后1年内发生再度穿孔6例(15%),两组术后并发症发生率比较差异无统计学意义(χ2=0.501, P=0.479)。 结论 耳内镜下耳屏软骨环-软骨膜修补术治疗鼓膜穿孔效果确切,可促进患者术后恢复,提高临床疗效及鼓膜愈合率,改善患者听力效果。

关键词: 鼓膜穿孔, 耳内镜, 耳屏软骨环-软骨膜, 疗效

Abstract: Objective To investigate the curative effect of endoscopic tragus cartilage ring perichondrium myringoplasty. Methods Eighty patients(80 ears)with tympanic membrane perforation were randomly divided into observation(endoscopic ear cartilage perichondrium composite ring repair)and control groups(temporalis fascia myringoplasty using an operating microscope), with 40 cases in each group. Clinical indexes, efficacy, tympanic membrane healing rates, hearing recovery, and the incidence of postoperative complications were compared between the two groups. Results The operative time and the amount of bleeding in the observation group were lower than those in the control group(P<0.05). The total efficacy rate in the observation group was higher than that in the control group(P<0.05). The tympanic membrane healing rate in the two groups was not statistically different after 1, 6, and 12 postoperative months(P>0.05). There was no significant difference in hearing recovery between the two groups after 1, 6, and 12 months(P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Use of endoscopic ear tragus cartilage ring perichondrium myringoplasty to reduce postoperative bleeding shortens the operative time and healing rate, with good clinical curative effect, and can improve hearing, making it clinically useful.

Key words: Auricular endoscopy, Tragus cartilage ring perichondrium, Tympanic membrane perforation, Curative effect

中图分类号: 

  • R764
[1] 王戬,葛前进,康利萍.鼓膜上皮皮瓣推移法修补边缘性鼓膜穿孔27例[J].山东大学耳鼻喉眼学报,2015,29(2):15-16. WANG Jian, GE Qianjin, KANG Liping. Advance flap in repairing marginal perforation of tympanic membrane in 27 cases[J]. J Otolaryngol Ophthal Shandong Univ, 2015, 29(2):15-16.
[2] 王进.内镜下与显微镜下鼓膜大穿孔软骨岛-软骨膜成形术差异分析[J].山东大学耳鼻喉眼学报,2014,28(1):8-9. WANG Jin. Repair of big tympanic membrane perforation with cartilage island-perichondrium under endoscopy and microscopy[J]. J Otolaryngol Ophthal Shandong Univ, 2014, 28(1):8-9.
[3] Yan K, Li J. Treatment of traumatic perforation of tympanic membrane with lens paper under ear endoscope[J]. J Clin Otorhinolaryngol Head Neck Surg, 2013, 27(24):1397.
[4] Habesoglu M, Oysu C, Sahin S, et al. Platelet-rich fibrin for the repair of tympanic membrane[J]. Otolaryngolo Head Neck Surg, 2012, 147(Suppl 2):218.
[5] 孔喆,李云英,向建文,等.言语测听体系评价中医药治疗耳聋耳鸣疗效研究[J].广州中医药大学学报,2017,34(1):47-50. KONG Zhe, LI Yunying, XIANG Jianwen, et al. Evaluation of therapeutic effect of chinese medicine for treatment of deafness and tinnitus with speech detection system[J]. J Guangzhou Univ Traditional Chin Med, 2017, 34(1):47-50.
[6] 王铁锋,徐亚萍.耳内镜下鼓膜大穿孔修补26例[J].中国眼耳鼻喉科杂志,2017,17(3):200-201. WANG Tiefeng, XU Yaping. 26 cases of large perforation of tympanic membrane under ear endoscopy[J]. Chin J Ophthalmol Otorhinolaryngol, 2017, 17(3):200-201.
[7] 程德军,钟锦婵,李少仪.耳内窥镜与显微镜下鼓膜修补术疗效比较[J].中外医学研究,2014,12(20):68-70. CHENG Dejun, ZHONG Jinchan, LI Shaoyi. Comparison of therapeutic effects of tympanoplasty under ear endoscope and microscope[J]. Chin Foreign Med Res, 2014, 12(20):68-70.
[8] Haksever M, Akduman D, Solmaz F, et al. Inlay butterfly cartilage tympanoplasty in the treatment of dry central perforated chronic otitis media as an effective and time-saving procedure[J]. Eur Arch Otorhinolaryngol, 2015, 272(4):867-872.
[9] 李惠,王俊国,钱晓云,等.鼻内镜下鼻中隔软骨、筛骨垂直板或耳屏软骨修补鼻中隔穿孔[J].现代生物医学进展,2017,17(14):2766-2769. LI Hui, WANG Junguo, QIAN Xiaoyun, et al. Nasal septum cartilage, ethmoidal vertical plate or ear cartilage for nasal septal perforation under nasal endoscope[J]. Prog Modern Biomed, 2017, 17(14):2766-2769.
[10] 张少燕,区永康,许耀东,等.耳屏双岛状软骨-软骨膜在上鼓室外侧壁重建及鼓室成形术的临床应用[J].中华显微外科杂志,2016,39(4):395-397. ZHANG Shaoyan, OU Yongkang, XU Yaodong, et al. Clinical application of double island cartilage cartilage membrane in reconstruction of lateral wall of upper drum and tympanoplasty[J]. Chin J Microsurg, 2016, 39(4):395-397.
[11] 杨启梅,张文,韩想利,等.耳内镜下耳屏软骨-软骨膜治疗鼓膜穿孔的临床研究[J].中华耳科学杂志,2016,14(6):778-782. YANG Qimei, ZHANG Wen, HAN Xiangli, et al. Clinical study of auricular cartilage cartilage membrane in the treatment of tympanic membrane perforation[J]. Chin J Otol, 2016, 14(6):778-782.
[12] 王驰,刘星,孔磊,等.耳内镜下耳屏软骨-软骨膜在鼓膜修补中的临床应用[J].现代仪器与医疗,2017,23(6):44-45. WANG Chi, LIU Xing, KONG Lei, et al. Clinical application of auricular cartilage cartilage membrane in tympanic membrane repair[J]. Modern Inst Med Treat, 2017, 23(6):44-45.
[13] 徐隽彦,刘春丽,倪立群.耳内镜下鼓膜置管或穿刺治疗慢性分泌性中耳炎的临床效果对比[J].中国耳鼻咽喉头颈外科,2015,22(1):21-23. XU Junyan, LIU Chunli, NI Liqun, et al. Comparison the clinical effect of tympanostomy tube and tympanocentesis under ear endoscope of chronic secretory otitis media[J]. Chin Arch Otolaryngol Head Neck Surg, 2015, 22(1):21-23.
[14] 薛建亭,朱宝福.内镜下蝶形耳屏软骨嵌入鼓膜修补术32耳[J].中国眼耳鼻喉科杂志,2017,17(4):272-274. XUE Jianting, ZHU Baofu. Effect of endoscopic inlay butterfly cartilage graft myringoplasty technique on the treatment of tympanic membrance perforation[J]. Chin J Ophthalmol Otorhinolaryngol, 2017, 17(4):272-274.
[15] 李鹏,张奕,符秋养,等.耳内镜下耳屏软骨-软骨膜修补鼓膜大穿孔的临床观察[J].临床耳鼻咽喉头颈外科杂志,2014,28(22):1762-1764. LI Peng, ZHANG Yi, FU Qiuyang, et al. The clinical observation of auricular cartilage cartilage membrane repair for large perforation of tympanic membrane under ear endoscope[J]. J Clin Otorhinolaryngol Head Neck Surg, 2014, 28(22):1762-1764.
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