中华耳科学杂志2025，Vol.23Issue(3)：412-417,6.DOI:10.3969/j.issn.1672-2922.2025.03.011
耳内镜下耳屏软骨-软骨膜复合体与软骨膜无翻瓣入路修补鼓膜穿孔的疗效分析
Endoscopic Repair of Tympanic Membrane Perforation with Tragus Cartilage-Perichondrium Complex and Perichondrium without Tympanomeatal Flap Elevation
刘莎 1仇静静 1刘大炜 1翟孝雨 1张强 1陈良 1孙岩1
作者信息
- 1. 青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科(烟台 264000) 山东省神经免疫互作与调控重点实验室 山东省耳鼻喉疾病临床医学研究中心 烟台市耳鼻喉疾病重点实验室
- 折叠
摘要
Abstract
Objective To report clinical outcomes of endoscopic tympanic membrane perforation repair with tragus cartilage-perichondrium complex and perichondrium without lifting the tympanomeatal flap.Methods Clinical data from 87 patients(87 ears)treated for tympanic membrane perforation at Yantai Yuhuangding Hospital,Qingdao University,from January 2021 to December 2023 were retrospectively analyzed.Techniques used included endoscopic medial(30 cases)and lateral(28 cases)faced grafting,and trans-perforation perichondrium grafting(29 cases),all without elevating the tympanomeatal flap.The cartilage-perichondrium clip with the perichondrium side facing either the tympanic cavity(medial)or the ear canal(lateral),whereas the tragus perichondrium was passed through the perforation in trans-perforation approach.Operation time,blood loss,grafting success rate,hearing outcomes and postoperative complications were compared among the techniques.Results The rate of success grafting was 96.67%(28/29)with medial facing chondroperichondrial clips,100%(28/28)with lateral facing chondroperichondrial clips,and 79.31%(17/23)with trans-perforation perichondrium grafts(P<0.05).Operation time with chondroperichondrial clips was significantly shorter than with trans-perforation perichondrium grafts(P<0.05),with no significant differences in blood loss,pre-and post-operative air-conduction threshold(AC)and air-bone gap(ABG)changes,and postoperative complications(P>0.05).Conclusion Compared with trans-perforation repair with tragus perichondrium,endoscopic composite chondroperichondrial clip tympanoplasty for repairing central perforation of 3～5 mm shows higher rates of grafting success with shorter operation time,and is worthy of adoption in clinical practice.关键词
鼓膜穿孔/鼓室成形术/耳软骨/耳内镜Key words
tympanic membrane perforation/tympanoplasty/ear cartilage/otoendoscope引用本文复制引用
刘莎,仇静静,刘大炜,翟孝雨,张强,陈良,孙岩..耳内镜下耳屏软骨-软骨膜复合体与软骨膜无翻瓣入路修补鼓膜穿孔的疗效分析[J].中华耳科学杂志,2025,23(3):412-417,6.
