Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringiti...Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.展开更多
目的观察带软骨膜软骨应用于鼓室成形术中治疗单侧慢性化脓性中耳炎传导性听力损失患者的干耳时间及听力恢复情况。方法选择单侧慢性化脓性中耳炎传导性听力损失患者121例,根据情况行开放式或完壁式鼓室成形术,并行一期或二期听骨链重...目的观察带软骨膜软骨应用于鼓室成形术中治疗单侧慢性化脓性中耳炎传导性听力损失患者的干耳时间及听力恢复情况。方法选择单侧慢性化脓性中耳炎传导性听力损失患者121例,根据情况行开放式或完壁式鼓室成形术,并行一期或二期听骨链重建。术中应用带软骨膜软骨作为鼓室支撑材料,颞肌筋膜修补。结果 121例患者中行一期听骨链重建71例,二期听骨链重建11例,未行听骨链重建只采用清除病变者39例。术后12个月,一期重建听骨链和二期重建骨链者平均骨气导差(air bone gap,ABG)均明显低于术前,差异有统计学意义(P<0.05);未行听力重建仅清除病变者ABG与术前比较差异无统计学意义(P>0.05)。结论带软骨膜软骨作为中耳支撑材料用于鼓室成形术可以维持鼓室容积,利于咽鼓管功能恢复,缩短干耳时间,有助于听力恢复。展开更多
文摘Background The main risk factors for postoperative failure in tympanoplasties are large perforations that are difficult to repair, annular perforations, and a tympanic membrane （TM） with extensive granular myringitis that require middle ear exploration and mastoidectomy. The aim of this study was to investigate a novel technique of perichondrium/cartilage composite graft for repairing the large TM perforation in the patient of otitis media. Methods Retrospective chart reviews were conducted for 102 patients with large tympanic membrane perforations, who had undergone tympanoplasty from August 2005 to August 2008. Tympanoplasty or tympanomastoidectomy using a perichondrium/cartilage composite graft was analyzed. The tragal or conchal perichondrium/cartilage was used to replace the tympanic membrane in patients. Results Patients aged from 13 to 67 years were followed up in average for 24 months （10-36 months）. Seventy-four ears （72.61%） were used the tragal perichondrium/cartilage as graft material and 27 ears （27.39%） were used the conchal perichondrium/cartilage. Graft take was successful in all patients. Postoperative complications such as wound infection, hematoma, or sensorineural hearing loss were not identified. Nine patients （8.82%） had the partial ossicular replacement prosthesis, 14 patients （13.72%） using the autologous curved incus and 79 patients （77.45%） without prosthesis. Successful closure occurred in 92% of the ears. A total of 85.8% patients achieved a postoperative hearing improvement. Conclusions The graft underlay tympanoplasty using perichondrium/cartilage composite is effective for the majority of patients with large perforation. The hearing was improved even if the mastoidectomy was required in the patients with otitis media with extensive granulation.
文摘目的观察带软骨膜软骨应用于鼓室成形术中治疗单侧慢性化脓性中耳炎传导性听力损失患者的干耳时间及听力恢复情况。方法选择单侧慢性化脓性中耳炎传导性听力损失患者121例,根据情况行开放式或完壁式鼓室成形术,并行一期或二期听骨链重建。术中应用带软骨膜软骨作为鼓室支撑材料,颞肌筋膜修补。结果 121例患者中行一期听骨链重建71例,二期听骨链重建11例,未行听骨链重建只采用清除病变者39例。术后12个月,一期重建听骨链和二期重建骨链者平均骨气导差(air bone gap,ABG)均明显低于术前,差异有统计学意义(P<0.05);未行听力重建仅清除病变者ABG与术前比较差异无统计学意义(P>0.05)。结论带软骨膜软骨作为中耳支撑材料用于鼓室成形术可以维持鼓室容积,利于咽鼓管功能恢复,缩短干耳时间,有助于听力恢复。
