摘要
Abstract
Objective To analyze the clinical effect of type Ⅰ tympanoplasty of the tragus cartilaginous perichondrium complex under otoendoscopy in improving the hearing of patients with chronic suppurative otitis media(CSOM).Method 98 patients with CSOM who underwent type Ⅰ tympanoplasty from June 2021 to June 2023 were selected.They were divided into group A and group B by the coin-toss method,with 49 cases in each group.Group A underwent tragus cartilaginous-perichondrium complex repair,and group B underwent temporal muscle fascia repair.Both groups of patients were followed up for 6 months after the operation.The perioperative indicators(operation time,intraoperative blood loss and healing time at the graft extraction site),bone conduction hearing threshold,air conduction hearing threshold and air-bone gap(A-B gap)before the operation,3 months after the operation and 6 months after the operation were compared between the two groups.The tinnitus handicap inventory(THI)score before the operation,1,3 and 6 months after the operation,the tympanic membrane healing status(complete healing,incomplete healing and tympanic membrane retraction/displacement)at 6 months after the operation,as well as the dry ear rate,dry ear duration and the occurrence of complications during the follow-up period were compared between the two groups.Results There were no statistically significant differences in the operation time,intraoperative blood loss and healing time of the graft extraction site between the two groups(P>0.05);The bone conduction hearing threshold,air conduction hearing threshold and A-B gap of the two groups at 3 and 6 months after the operation showed a gradually decreasing trend compared with those before the operation,and group A was significantly lower than group B,the comparisons of intergroup,time and interaction effects all showed statistically significant differences(P<0.05);At 1,3 and 6 months after the operation,the THI scores of the two groups of patients showed a gradually decreasing trend compared with those before the operation,and the THI score of group A was significantly lower than that of group B,the comparisons of intergroup,time and interaction effects all showed statistically significant differences(P<0.05);Six months after surgery,group A exhibited a significantly higher healing rate compared with group B(P<0.05).During the follow-up period,the dry ear rate in group A was 95.92％(47/49),significantly higher than 83.67％(41/49)in group B,the dry ear time was(10.94±1.31)weeks in group A,significantly shorter than(12.56±1.28)weeks in group B,the differences were statistically significant(P<0.05);There was no statistically significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Compared with temporal muscle fascia repair,tragus cartilaginous-perichondrium complex repair for CSOM can significantly improve the hearing level and dry ear rate of patients,alleviate tinnitus,shorten the dry ear time,and has high safety.It is worthy of clinical promotion and application.关键词
慢性化脓性中耳炎/Ⅰ型鼓室成形术/耳屏软骨-软骨膜复合体修补术/颞肌筋膜修补术/治疗效果/预后Key words
chronic suppurative otitis media/type I tympanoplasty/tragus cartilaginous perichondrium complex/temporal fascia repair surgery/therapeutic effect/prognosis分类
医药卫生
