鼓膜边缘缺失患者的鼓膜成形术临床分析

发布时间：2018-07-28 09:51

【摘要】：目的探讨鼓膜边缘缺失的鼓膜成型方法和注意点。方法 39例(48耳,19例男性),均年龄50.92岁(范围26-83岁),病程均12.5年(范围10-20年)。鼓环部分或大部分缺失。术前平均气骨导差(ABG)30.16±8.76d B(范围13-55d B),气导(AC)43.64±11.03d BHL(范围22-72d BHL),骨导(BC)13.68±9.47d BHL(范围1-39d BHL)。2006-2013年间手术。一些如保护残余鼓膜前下方关键点被覆上皮和移植的骨膜顶嵌入等确保愈合方法。以及减少电钻噪声刺激、减少听骨位移等预防感音功能受损技术方法。结果 48耳随访12月以上。穿孔全部愈合。无面瘫、眩晕、耳鸣等并发症。术后AC27.56±12.19d BHL,GAP12.39±8.54d B与术前相比,U值分别为6.77和10.06,都u0.01=2.57,p0.01,差异都有极显著性意义。术后BC13.9±9.95d BHL,与术前相比,U值=0.11u0.05=1.96,p0.05,差异没有显著性意义。术后GAP缩小到10d B以内23耳(48%),11-20d B者16耳内(33%)。AC除5耳(10%)外都在40d B以内。结论如果操作技术得当,鼓膜边缘缺失仍能取得满意效果
[Abstract]:Objective to explore the methods and points of attention for tympanic membrane formation with missing tympanic membrane edge. Methods 39 patients (19 males with 48 ears), all aged 50.92 years (range 26-83 years), had an average duration of 12.5 years (range 10-20 years). Missing part or most of the drum ring. The mean air-bone conduction difference (ABG) was 30.16 卤8.76 dB (range 13-55 d B), (AC) 43.64 卤11.03 d BHL) (range 22-72 d BHL), (BC) 13.68 卤9.47 d BHL (range 1-39 d BHL). Some ways to ensure healing, such as protecting the epithelium at the key point below the residual tympanic membrane and embedding the transplanted periosteum top. And the methods to prevent the damage of sensory sound function, such as reducing noise stimulation of drill and reducing displacement of auditory bone, etc. Results 48 ears were followed up for more than 12 months. The perforation healed in full. No facial paralysis, vertigo, tinnitus and other complications. AC27.56 卤12.19 d BHLN GAP12.39 卤8.54 d B were 6.77 and 10.06 respectively compared with those before operation, and there were significant differences between the two groups. There was no significant difference in BC13.9 卤9.95 days after operation between BHLs and preoperative BHLs (0.11u 0.05 卤1.96 p 0.05). After operation, GAP was reduced to 23 ears (48%) within 10 d B (48%), 16 ears (33%) with 11 to 20 d B. Ac was within 40 d B except 5 ears (10%). Conclusion if the technique is proper, the loss of tympanic membrane edge can still achieve satisfactory results.
【作者单位】：江苏省苏州市眼耳鼻喉科医院耳鼻喉科;上海市第一人民医院分院耳鼻喉科;
【分类号】：R764.92

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