颞筋膜移植I型鼓室成形术后听力学结果的临床研究

K. Sudhakar, Nitish Agarwal, Iachika Sethi, Junior Resident
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简介:慢性化脓性中耳炎引起的鼓膜穿孔是非常常见的。鼓室成形术是一种修复TM穿孔的一般手术方法。本研究的目的是评估使用颞筋膜作为移植物的I型鼓室成形术后的听力结果。材料与方法:本横断面研究在耳鼻喉科进行。共选择n=65例患者,其中男性35例,女性30例。所有病例均行耳后鼓室成形术,取材于颞筋膜,经下垫入路作为自体移植物。然后用索霉素包封外耳道。手术第7天取出缝合线和软霉素包。类固醇鼻腔喷雾剂2个月,同时建议使用抗生素和减充血剂2周。每隔1个月随访3个月,每隔6个月随访6个月。结果:主要穿孔29例(44.61%),小于50%,其次为中孔21例(32.30%),大孔15例(23.07%)。在n=65例患者中,移植总成功率为n=61(93.84%)例,移植摄取率为n=63(96.92%)例。整体听力改善记录:男性术前平均气骨传导23.5±3.2 dB,术后3个月平均AB间隙8.61±1.7 dB,增益14.89±1.50,女性术前平均AB传导22.1±2.8 dB,术后平均AB传导6.72±1.39,增益10.60±1.41。结论:颞筋膜型鼓室成形术治疗干耳型中枢性耳穿孔效果较好。几乎所有患者都注意到听力改善形式的听力学结果。
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A clinical study of audiological outcome following type I tympanoplasty using temporalis fascia as graft
Introduction: Tympanic membrane perforations caused by chronic suppurative otitis media are very frequent. Tympanoplasty is a general surgical practice for the repair of TM perforation. The aim of the present study was to evaluate the hearing outcomes following type I tympanoplasty using temporalis fascia as a graft. Materials and Methods: This cross-sectional study was carried out in the Department of ENT. A total of n=65 patients n=35 male and n=30 female were selected. All the cases underwent tympanoplasty through post aural technique using harvested temporalis fascia as the autograft material by underlay approach. The external auditory meatus was then packed with soframycin pack. Sutures and soframycin pack was taken out on the 7 day of operation. Steroid nasal spray for 2 months along with antibiotics and decongestants which were advise for 2 weeks. The patients were followed at the one-month interval for 3 months than at 6 months. Results: The prevailing perforations were (less than 50% of the TM) found in n=29 (44.61%) of the patients followed by medium size perforations n=21 (32.30%) and large perforations were found in n=15 (23.07%). The overall success rate of the graft was n=61 (93.84%) patients out of n=65 patients and the graft uptake was found in n=63(96.92%) of the patients. The overall improvement of hearing recorded the mean preoperative air-bone conduction in male prior to the operation was 23.5±3.2 dB and mean postoperative AB gap after 3 months was 8.61±1.7 dB and the gain was 14.89±1.50 similarly in females the mean preoperative AB conduction was 22.1±2.8 dB and mean postoperative AB conduction was 6.72±1.39 the gain was 10.60±1.41. Conclusion: Type I tympanoplasty with temporalis fascia is reasonably successful for the treatment of central perforations with dry ears. The audiological outcomes in the form of hearing improvements were noticed in almost all of the patients.
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