颞筋膜移植与颞筋膜软骨移植的对比研究

A. Dayananad, B. Harshavardhan, J. Dheebika, S. Palaninathan
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摘要

背景:本分析研究的目的是比较单独使用颞筋膜和软骨作为移植材料的颞筋膜在I型鼓室成形术中的听力改善。材料与方法:本研究于2016年10月至2018年7月在PSGIMSR耳鼻喉科完成。在研究期间,共有21453例患者在耳鼻喉科门诊就诊。其中,75例鼓膜干性穿孔被选为研究对象。随机选择患者,排除耳漏、中耳炎和慢性中耳炎并发症。结果:在研究人群中,鼻子和喉咙的疾病也被排除在外。详细评估每个病例包括病史,临床检查,调查包括纯音听力学。患者分为两组。A组50例患者行单纯颞筋膜I型鼓室成形术。B组25例患者行颞筋膜-耳甲软骨联合I型鼓室成形术。比较两组术后听力学测量的听力改善情况,发现颞筋膜瓣移植术后小穿孔改善效果最好,颞筋膜瓣联合耳甲软骨移植术后大穿孔和次全穿孔改善效果较好。结论:颞肌移植组平均听力改善12.98 dB(优于B组),颞筋膜+耳蜗软骨移植组平均听力改善8.96 dB。
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Study on temporalis fascia graft versus temporalis fascia with cartilage graft
Background: The aim of this analytical study is to compare the hearing improvement in type I Tympanoplasty between Temporalis Fascia used alone and temporalis Fascia with cartilage as graft material. Material and Methods: The study was done in ENT department at PSGIMSR, from October 2016 to July 2018. A total of 21,453 cases attended the ENT Outpatient department during the study period. Out of these, 75 cases with dry perforation of the tympanic membrane were chosen for the study. Patients were selected in random, excluding ear discharge, Attico-antral disease, and complications of chronic otitis media. Results: In the study population, disease afflicting the nose and throat were also ruled out. Detailed evaluation of each case was done comprising of history taking, clinical examination, investigations including pure tone audiometry. Patients were divided into 2 groups. Group A consist of 50 patients underwent type I Tympanoplasty with temporalis fascia alone. Group B consist of 25 patients underwent type I Tympanoplasty with combined Temporalis Fascia & Conchal Cartilage. Post-operative hearing improvement measured by Audiometry is compared among the two groups and found that small perforations had best improvement with Temporalis Fascia graft, large and subtotal perforation had good improvement in postoperative hearing with combined Temporalis Fascia and Conchal Cartilage graft. Conclusion: Mean hearing improvement in Group A with temporalis graft was 12.98 dB (better) than Group B, with Temporalis Fascia & Cochal Cartilage graft mean hearing improvement was 8.96 dB.
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