摘要
Abstract
Objective To report outcomes of endoscopic type Ⅰ tympanoplasty under for chronic suppurative otitis media(CSOM)complicated by fungal infection in the external auditory canal.Methods Cases of CSOM with complete medical records that underwent endoscopic type Ⅰ tympanoplasty at the Department of Otorhinolaryngology,the Second Affiliated Hospital of Soochow University,from January 2022 to June 2024(n=159)were retrospective analyzed.All patients were divided into groups based on presence/absence of fungal infection and ear discharge,i.e.no fungal infection(n=99),with fungal infection but dry ear(n=39),and with fungal infection and wet ear(n=21).All patients were followed up regularly after surgery.The rate of graft uptake,hearing improvement and conditions of external auditory canal were compared.Results The rate of tympanic membrane healing at 3rd months was 97.9%(97/99)in patients without fungal infection with the mean air conduction(AC)threshold improved from 37.77±11.92 dB HL preoperatively to 28.38±11.68 dB HL postoperatively(P＜0.001),94.9%(37/39)in patients with fungal infection but dry ear with the AC thresholds improved from 39.84±12.43 dB HL to 30.99±11.50 dB HL(P=0.002),and 95.2%(20/21)in patients with fungal infection and wet ear with the AC threshold improved from 40.42±13.23 dB HL to 31.85±12.59 dB HL(P=0.038),showing no significant difference among the three groups(P=0.408).Postoperative hearing improvement in the three groups was 8.94±4.09 dB HL,8.56±3.40 dB HL and 9.35±3.27 dB HL,respectively(P=0.739).The rate of dry ear at 2nd week after surgery for the three groups was higher in patients without fungal infection(69.7%)and those with fungal infection dry ear(66.7%)than in patients with fungal infection and wet ear(33.3%).The rate,however,was 94.9%,92.3%and 90.5%at 1st month after surgery,and 99.0%,97.4%and 90.5%at 3rd month after surgery for the three groups,respectively(P=0.056).Conclusions For patients without ossicular chain lesions,CSOM complicated by external auditory canal otomycosis is not a surgical contraindication.Endoscopic type Ⅰ tympanoplasty can achieve satisfactory graft uptake rates and hearing improvement.However,it should be noted that the dry ear time may be delayed in patients with wet ear preoperatively.关键词
鼓室成型/慢性化脓性中耳炎/外耳道真菌/耳内镜Key words
tympanoplasty/chronic suppurative otitis media/otomycosis/oto-endoscope
