摘要
目的分析不同显微技术下经外耳道入路鼓室成形术治疗慢性中耳炎的疗效。方法回顾性选取2019年1月至2023年12月至张家港市第一人民医院接受经外耳道入路鼓室成形术治疗的107例慢性中耳炎患者,根据手术方式不同分为显微镜组(n=52)和耳内镜组(n=55)。显微镜组行显微镜下经外耳道入路鼓室成形术,耳内镜组行耳内镜下经外耳道入路鼓室成形术。比较两组患者临床指标(手术时间、术中出血量、鼓室成形术分型及住院时间)、手术前后听力情况[气导听阈、骨导听阈及气骨导差(ABG)]、中文版慢性耳病调查量表(CCES)评分及并发症。结果耳内镜组手术时间、术中出血量及住院时间分别为(95.73±18.22)min、(7.96±1.83)mL、(4.87±0.35)d,均少于显微镜组[(108.45±21.36)min、(10.14±2.25)mL、(5.26±0.49 d],差异均有统计学意义(P<0.05);两组患者鼓室成形术分型比较,差异无统计学意义(P>0.05)。两组患者手术前后气导听阈、骨导听阈及ABG比较,差异均无统计学意义(P>0.05);两组患者手术后气导听阈、ABG均低于手术前,差异均有统计学意义(P<0.05)。手术前,两组患者CCES各维度及总分比较,差异均无统计学意义(P>0.05);手术后,两组患者CCES各维度及总分高于手术前,且耳内镜组高于显微镜组,差异均有统计学意义(P<0.05)。两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论经显微镜和经耳内镜鼓室成形术均可用于治疗慢性中耳炎,可有效改善患者术后听力,安全可行,但经耳内镜术式可减少手术时间和术中出血量,改善患者生活质量,促进患者快速康复。
Objective To analyze the effect of tympanoplasty via external auditory canal under different microsurgical techniques in the treatment of chronic otitis media.Methods A retrospective study was conducted.A total of 107 patients with chronic otitis media who underwent tympanoplasty via external auditory canal at Zhangjiagang First People's Hospital from January 2019 to December 2023 were enrolled in this study.According to the surgical method,patients were divided into the microscope group(n=52)and the endotoscope group(n=55).The microscope group underwent tympanoplasty via external auditory canal under the microscope,while the endotoscope group underwent tympanoplasty via external auditory canal under the endotoscope.Clinical indicators(operation time,intraoperative blood loss,classification of tympanoplasty and hospitalization time),preoperative and postoperative hearing[air conduction hearing threshold,bone conduction hearing threshold and air-bone gap(ABG)],Chinese version of the chronic ear survey(CCES)scores,and complications were compared between the groups.Results The operation time,intraoperative blood loss and hospitalization time in the endoscopic group were(95.73±18.22)min,(7.96±1.83)mL and(4.87±0.35)d,respectively,which were less than those in the microscope group[(108.45±21.36)min,(10.14±2.25)mL and(5.26±0.49)d],and the differences were statistically significant(P<0.05);there was no statistically significant difference in the classification of tympanoplasty between the groups(P>0.05).There was no significant difference in air conduction hearing threshold,bone conduction hearing threshold and ABG between the two groups before and after operation(P>0.05).The air conduction hearing threshold and ABG of the two groups after operation were lower than those before operation,and the differences were statistically significant(P<0.05).Before operation,there was no significant difference in each dimension and total score of CCES between the two groups(P>0.05).After surgery,the dimensions and total scores of CCES in the two groups were higher than those before surgery,and those in the endoscopic group were higher than the microscope group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the groups(P>0.05).Conclusion Tympanoplasty under microscope and endotoscope both can be used to treat chronic otitis media.Both can effectively improve the patients'postoperative hearing and are safe and feasible.However,tympanoplasty under endotoscope can shorten surgical time,reduce intraoperative blood loss,improve the quality of life,and promote recovery.
作者
袁毅方
余艳
吴革平
刘剑勇
YUAN Yi-fang;YU Yan;WU Ge-ping(Department of Otorhinolaryngology,Zhangjiagang First People's Hospital,Zhangjiagang Jiangsu 215600,China)
出处
《临床和实验医学杂志》
2024年第20期2215-2219,共5页
Journal of Clinical and Experimental Medicine
基金
江苏大学临床医学科技发展基金研究项目(编号:JLY2921124)。
关键词
显微镜
耳内镜
经外耳道入路
鼓室成形术
慢性中耳炎
疗效
Microscope
Endotoscope
External auditory canal approach
Tympanoplasty
Chronic otitis media
Therapeutic effect
