Objective To explore the application value of the ear shield cartilage-bilateral cartilage membrane composite under ear endoscopy in repairing large perforations of the tympanic membrane.Methods 79 patients(79 ears)with large perforations of the tympanic membrane treated in the Department of Otolaryngology-Head and Neck Surgery,Jinhua Hospital Affiliated to Zhejiang University School of Medicine from January 2021 to January 2023 were included in this study.They were divided into a study group(40 cases treated with ear shield cartilage-bilateral cartilage membrane composite for tympanic membrane repair)and a control group(39 cases treated with temporal muscle fascia for tympanic membrane repair).All patients underwent one-stage surgery using the internal implantation method.Pure-tone audiometry and ear endoscopy were performed 3 months after surgery to analyze the tympanic membrane healing rate,healing morphology,and hearing improvement.Results Three months after surgery,ear endoscopy showed that the tympanic membrane healing rate in the study group(100% )was higher than that in the control group(92.31% ).The morphology of the tympanic membrane in the study group was better than that in the control group.Three months after surgery,pure-tone audiometry showed that the air-bone gap difference before and after treatment in the study group was(22.09±3.71)dB HL and(10.06±2.68)dB HL,respectively,and the difference was statistically significant(P<0.05).In the control group,the air-bone gap difference before and after treatment was(21.79±5.83)dB HL and(10.58±3.37)dB HL,respectively,and the difference was statistically significant(P<0.05).There was no significant difference in the air-bone gap difference between the two groups after treatment(P>0.05).Conclusion The ear shield cartilage-bilateral cartilage membrane composite used for repairing large perforations of the tympanic membrane under ear endoscopy can reduce the difficulty of material acquisition during surgery and improve postoperative hearing.It is a reliable repair material and worthy of clinical application.
OtoscopeTragus cartilage-perichondrium complexTympanoplastyTympanic Membrane large PerforationTemporal muscle fascia
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