Effect of different thickness of tragus cartilage-perichondrium complex in the treatment of tympanic membrane perforation secondary to suppurative otitis media

HUANG Xu-xin; DONG Chen; REN Ya-ling; ZHANG Ye

doi:10.11659/jjssx.07E022049

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Effect of different thickness of tragus cartilage-perichondrium complex in the treatment of tympanic membrane perforation secondary to suppurative otitis media

Clinical Research | 更新时间：2023-05-26

- Effect of different thickness of tragus cartilage-perichondrium complex in the treatment of tympanic membrane perforation secondary to suppurative otitis media
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 32, Issue 5, Pages: 409-412(2023)
- 作者机构：
  
  空军军医大学第一附属医院耳鼻咽喉头颈外科，陕西西安 710032
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.07E022049
  CLC： R764.2
- Published：25 May 2023，
  
  Received：14 July 2022，
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黄绪昕,董晨,任亚玲等.不同厚度耳屏软骨-软骨膜复合体在治疗化脓性中耳炎继发鼓膜穿孔中的效果[J].局解手术学杂志,2023,32(05):409-412.

HUANG Xu-xin,DONG Chen,REN Ya-ling,et al.Effect of different thickness of tragus cartilage-perichondrium complex in the treatment of tympanic membrane perforation secondary to suppurative otitis media[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):409-412.
黄绪昕,董晨,任亚玲等.不同厚度耳屏软骨-软骨膜复合体在治疗化脓性中耳炎继发鼓膜穿孔中的效果[J].局解手术学杂志,2023,32(05):409-412. DOI： 10.11659/jjssx.07E022049.

HUANG Xu-xin,DONG Chen,REN Ya-ling,et al.Effect of different thickness of tragus cartilage-perichondrium complex in the treatment of tympanic membrane perforation secondary to suppurative otitis media[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):409-412. DOI： 10.11659/jjssx.07E022049.

摘要

目的

分析不同厚度耳屏软骨-软骨膜复合体在治疗化脓性中耳炎继发鼓膜穿孔中的效果。

方法

选取在我院治疗的化脓性中耳炎继发鼓膜穿孔患者168例为研究对象，按照随机数字表法分为观察组和对照组，每组84例。2组患者均接受鼓膜修补术治疗，观察组使用全厚耳屏软骨-软骨膜复合体修复材料，对照组使用半厚耳屏软骨-软骨膜复合体修复材料。观察2组患者术后外耳道形态，对比2组患者手术时间、住院时间、术中出血量、切口愈合时间及术前和术后3个月纯音听阈、疼痛视觉模拟评分法（VAS）评分、气导平均听阈、平均气骨导差，统计2组患者术后3个月并发症发生情况及术后3年复发率。

结果

观察组术后外耳道形态正常率显著高于对照组（

0.05）。2组患者手术时间、住院时间、术中出血量、切口愈合时间及术前和术后3个月纯音听阈、VAS评分、气导平均听阈和平均气骨导差对比，差异均无统计学意义（

0.05）。观察组术后3个月并发症总发生率为7.14%，显著低于对照组的23.81%（

0.05）。随访3年，观察组总复发率为18.42%，显著低于对照组的41.10%（

0.05）。

结论

鼓膜修补术中使用全厚耳屏软骨-软骨膜复合体修复材料治疗化脓性中耳炎继发鼓膜穿孔可有效重塑外耳道形态，且并发症较少，复发率较低。

Abstract

Objective

To analyze the effects of different thickness of tragus cartilage-perichondrium complexex in the treatment of tympanic membrane perforation secondary to suppurative otitis media.

Methods

A total of 168 patients with tympanic membrane perforation secondary to suppurative otitis media treated in our hospital were selected as the research objects

and they were divided into the observation group and the control group according to the random number table method

with 84 patients in each group.All patients in the two groups were treated with tympanic membrane repair

in which the observation group used the full-thickness tragus cartilage-perichondrium complex repair material

while the control group used the half-thickness tragus cartilage-perichondrium complex repair material.The postoperative morphology of external auditory canal was observed between the two groups.The operation time

hospital stay

intraoperative blood loss

wound healing time and the pure tone audiology thresholds

visual analogue scale (VAS) score

mean air conducted auditory thresholds and mean air bone gap before surgery and 3 months after surgery of the two groups were compared.The incidence of complications 3 months after surgery and the recurrence rate 3 years after surgery were analyzed.

Results

The normal rate of external auditory canal morphology in the observation group was significantly higher than that in the control group (

0.05).There was no significant difference in the operation time

hospital stay

intraoperative blood loss

wound healing time

pure-tone auditory thresholds

VAS score

mean air conducted auditory thresholds

or mean air bone gap before surgery and 3 months after surgery between the two groups (

0.05).The total incidence of complications 3 months after surgery in the observation group was 7.14%

which was significantly lower than 23.81% in the control group (

0.05).During the 3-year follow-up

the total recurrence rate of the observation group was 18.42%

which was significantly lower than 41.10% in the control group (

0.05).

Conclusion

The use of full-thickness tragus cartilage-perichondrium complex repair material in tympanic membrane repair for the treatment of tympanic membrane perforation secondary to suppurative otitis media can effectively reshape the morphology of external auditory canal with less complications and lower recurrence rate.

关键词

修复材料厚度化脓性中耳炎鼓膜穿孔鼓膜修补术外耳道形态耳屏软骨-软骨膜复合体

Keywords

repair material thicknesssuppurative otitis mediatympanic membrane perforationtympanic membrane repairmorphology of external auditory canaltragus cartilage-perichondrium complex

references

陈慧慧，朱运华，姚银辉，等.清热散结片联合左氧氟沙星滴耳液治疗化脓性中耳炎的临床研究［J］.现代药物与临床，2020，35（6）：1222-1225.doi：10.7501/j.issn.1674-5515.2020.06.035http://dx.doi.org/10.7501/j.issn.1674-5515.2020.06.035.

金燕，赵红燕.递进式护理模式对慢性化脓性中耳炎患者继发性鼓膜穿孔发生率及复诊率的影响［J］.现代中西医结合杂志，2019，28（14）：1581-1583.doi：10.3969/j.issn.1008-8849.2019.14.027http://dx.doi.org/10.3969/j.issn.1008-8849.2019.14.027.

罗维.耳内镜下应用耳屏软骨-软骨膜复合体行鼓膜修补术的临床应用［J］.中国医学创新，2012，9（17）：99-100.doi：10.3969/j.issn.1674-4985.2012.17.064http://dx.doi.org/10.3969/j.issn.1674-4985.2012.17.064.

刘得龙，潘涛，李政，等.鼓膜穿孔患者耳内镜下带软骨膜耳屏软骨复合体行空鼓室鼓膜修补术的效果观察［J］.中国医师进修杂志，2021，44（7）：661-664.doi：10.3760/cma.j.cn115455-20201209-01782http://dx.doi.org/10.3760/cma.j.cn115455-20201209-01782.

中华医学会.临床诊疗指南.耳鼻咽喉科学分册［M］.北京：人民卫生出版社，2009：168-169.

孙兵，车晓明.视觉模拟评分法（VAS）［J］.中华神经外科杂志，2012，28（6）：645.

宋勇莉，黄立桂，温立婷，等.慢性化脓性中耳炎患者耳鸣的特点及影响因素分析［J］.听力学及言语疾病杂志，2019，27（1）：38-41.doi：10.3969/j.issn.1006-7299.2019.01.009http://dx.doi.org/10.3969/j.issn.1006-7299.2019.01.009.

Meng W，Huang DD，Li GF，et al.Evaluation of clinical graded treatment of acute nonsuppurative otitis media in children with acute upper respiratory tract infection［J］.Neural Plast，2021，2021：5517209.doi：10.1155/2021/5517209http://dx.doi.org/10.1155/2021/5517209.

席庆明.耳内镜下鼓室成形术应用效果分析和临床体会［J］.医学与哲学，2018，39（6）：54-56.doi：10.12014/j.issn.1002-0772. 2018.03b.15http://dx.doi.org/10.12014/j.issn.1002-0772.2018.03b.15.

Umamaheswaran P，Mohanty S，Manimaran V，et al.A comparative study of sequential vs.simultaneous type Ⅰ tympanoplasty in patients with bilateral chronic otitis media-mucosal type［J］.J Otol，2020，15（2）：59-61.doi：10.1016/j.joto.2019.12.005http://dx.doi.org/10.1016/j.joto.2019.12.005.

侯晓燕，孙敬武，孙家强.耳内镜下软骨膜-软骨岛在鼓膜修补术中应用的效果分析［J］.中国耳鼻咽喉头颈外科，2020，27（7）：386- 389.doi：10.16066/j.1672-7002.2020.07.006http://dx.doi.org/10.16066/j.1672-7002.2020.07.006.

熊辉强，徐义香，夏良勇，等.耳内镜下自体不同修复材料在鼓膜修补术中的疗效比较［J］.江西医药，2020，55（8）：1115-1117.doi：10.3969/j.issn.1006-2238.2020.08.046http://dx.doi.org/10.3969/j.issn.1006-2238.2020.08.046.

Lou Z.Is a biological scaffold needed for the repair of traumatic tympanic membrane perforations？［J］.Otolaryngol Head Neck Surg，2021，164（2）：451-452.doi：10.1177/0194599820962468http://dx.doi.org/10.1177/0194599820962468.

姜妍，李江平，王鹏举，等.耳内镜下鼓室成形术鼓膜穿孔修复材料的比较［J］.听力学及言语疾病杂志，2019，27（6）：623-625.doi：10.3969/j.issn.1006-7299.2019.06.010http://dx.doi.org/10.3969/j.issn.1006-7299.2019.06.010.

Lou ZC.The effects of everted or inverted edges on healing of traumatic-induced tympanic membrane perforations［J］.J Laryngol Otol，2019，133（12）：1092-1096.doi：10.1017/S0022215119002445http://dx.doi.org/10.1017/S0022215119002445.

闫强.耳内镜下耳屏软骨-软骨膜复合体行鼓室成形术对鼓膜愈合及听力恢复影响效果［J］.中国疗养医学，2019，28（10）：

1077-1079.doi：10.13517/j.cnki.ccm.2019.10.026http://dx.doi.org/10.13517/j.cnki.ccm.2019.10.026.

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