目的 探讨耳屏软骨环—软骨膜在鼓膜大穿孔修补中的应用,并对影响其远期疗效的相关因素进行分析.方法 2004年1月~2013年12月在我院行耳屏软骨环—软骨膜鼓膜成形术的325例(375耳)患者的临床资料进行分析;观察指标:年龄,病程,干耳时间,术前气导听阈,术后骨导听阈,鼓室粘膜状况,鼓室硬化灶,听骨重链病变,咽鼓管功能,术中创面渗血;随访3年以上,用SPSS 16.2软件进行χ2检验和多元线性回归分析,以P<0.05为差异有统计学意义.结果 本组病例年龄11~62岁,平均(36±8.32)岁,病程1年至36年,平均(21±7.62)年;1年鼓膜愈合率为94.8%,3年愈合率为91.6%;其影响手术效果的因素,经多因素分析其作用依次为:鼓室硬化斑灶,术前气导听阈,术前骨导听阈,病程,咽鼓管功能,术中创面渗血具相关性.结论 影响耳屏软骨环—软骨膜鼓室成形术成功率的因素有:鼓室硬化灶、病程长短、咽鼓管功能有关、术前气骨导听阈损失状况,术中创面渗血明显也影响手术效果.%Objective To report repair of large tympanic membrane perforation using tragus cartilage ring-peri-chondrium grafts and factors that can affect the long-term outcomes.Methods From January 2004 to December 2013, tragus Cartilage ring perichondrium grafts were used during myringoplasty in 325 patients(375 ears).Their clinical da-ta,including age,duration of dry ear,preoperative air conduction hearing threshold,postoperative bone conduction hear-ing threshold,tympanic mucosa condition,tympanosclerosis lesions,ossicular chain lesion,Eustachian tube function,in-traoperative blood oozing and follow-up data(more than 3 years),were analyzed using the SPSS 16.2 software.χ2 test and multiple linear regression analysis were employed with P<0.05 being statistically significant.Results The mean age of our patients was 36±8.32(11-62)years and the average disease duration was 21±7.62(1-36)years.The rate of tym-panic membrane healing was 94.8% at 1 year and 91.6% at 3 years.Multivariate analysis of factors influencing opera-tion results indicated correlation to the following:tympanosclerotic plaque lesions,preoperative air conduction hearing threshold,preoperative bone conduction hearing threshold,duration of disease,eustachian tube function and intraopera-tive blood oozing.Conclusion Tympanosclerotic plaque lesions,preoperative air conduction hearing threshold,duration of disease,eustachian tube function and intraoperative blood oozing appear to affect the efficacy of tympanoplasty using tragus cartilage ring-perichondrium grafts.
展开▼
