鼓膜软骨塑形器在耳内镜下Ⅰ型鼓室成形术中的应用及疗效分析
Application and efficacy analysis of tympanic cartilage shaping device in endoscopic type Ⅰ tympanoplasty
金毅 1贺楚峰 1蔡鑫章 1吴学文 1蒋璐 1吴丽莎 1吴宏 1刘畅 1宋剑 1梅凌云1
作者信息
- 1. 中南大学湘雅医院耳鼻咽喉头颈外科 耳鼻咽喉重大疾病湖南省重点实验室 国家老年疾病临床医学研究中心(湘雅医院)(长沙,410008)
- 折叠
摘要
目的:研究运用鼓膜软骨塑形器塑形软骨在耳内镜下Ⅰ型鼓室成形术中的可行性和疗效.方法:通过高分辨率CT(HRCT)影像学测量鼓膜尺寸设计制造一种鼓膜软骨塑形器,用于裁剪和塑形软骨以修补鼓膜.选取2019年8月-2021年10月中南大学湘雅医院耳鼻咽喉头颈外科66例(72耳)慢性化脓性中耳炎患者应用此软骨塑形器在耳内镜下完成Ⅰ型鼓室成形术,术后对鼓膜愈合情况、听力恢复效果等进行观察.术后随访3～24个月,平均9个月.采用SPSS 26.0软件对数据进行统计学分析.结果:根据影像测量鼓膜紧张部宽为(8.60±0.20)mm、高为(8.64±0.19)mm,设计内径8.60 mm的圆筒状软骨塑形器.用鼓膜软骨塑形器塑形的软骨软骨膜复合物行鼓室成形术后,鼓膜愈合率为100％;术前平均气骨导差为(23.10±7.33)dB,术后1个月平均气骨导差缩小为(16.80±6.10)dB,差异有统计学意义(t=7.831,P＜0.05);术后3个月平均气骨导差为(14.30±6.40)dB较术后1个月进一步缩小,差异亦有统计学意义(t=6.630,P＜0.05).结论:鼓膜软骨塑形器塑形软骨在耳内镜下鼓室成形术中应用简便、稳定、可靠,可以减少移植物软骨处理时间,提高手术效率,术后鼓膜形态和功能恢复好.
Abstract
Objective:To study the feasibility and efficacy of using a tympanic cartilage shaping device in endoscopic type Ⅰ tympanoplasty.Methods:A tympanic cartilage shaper was designed and manufactured by measuring tympanic membrane dimensions with HRCT imaging for cutting and shaping cartilage to repair the tympanic membrane.From Au-gust 2019 to October 2021,66 patients(72 ears)with chronic suppurative otitis media in Xiangya Hospital underwent en-doscopic type Ⅰ tympanoplasty with this tympanic cartilage shaping device,and were observed the tympanic membrane healing and hearing recovery effect after surgery.Postoperative follow-up ranged from 3-24 months,with an average of 9 months.The data were analyzed by the SPSS 26.0 software.Results:According to the imaging measurements,tympanic pars tensa width(8.60±0.20)mm,height(8.64±0.19)mm,design and manufacture a cylindrical cartilage shaping de-vice with inner diameter 8.60 mm.After tympanoplasty,the healing rate of tympanic membrane was 100％;The aver-age air-bone gap before surgery was(23.10±7.33)dB,then(14.30±6.40)dB 1 month after surgery,which were sig-nificant reduced compared with those before surgery.The average air-bone gap was(14.30±6.40)dB 3 month after sur-gery compared with 1 month after surgery,the difference was also statistically significant(t=6.630,P＜0.05).Conclu-sion:The tympanic membrane cartilage shaper shaping cartilage in endoscopic tympanoplasty is simple,stable and relia-ble,which can reduce the time of graft cartilage processing,improve the efficiency of surgery,and restore the tympanic membrane morphology and function in the postoperative period.
关键词
鼓膜软骨塑形器/鼓室成形术/耳内镜手术/软骨Key words
tympanic cartilage shaping device/tympanoplasty/endoscopic surgery/cartilage引用本文复制引用
出版年
2024
NETL
NSTL
万方数据