| 李士强,王伟,强化龙,等.耳内镜下摘除砧骨体及鼓室成形术治疗局限性上鼓室病变伴鼓膜穿孔30 例疗效分析[J].安徽医药,2022,26(9):1846-1849. |
| 耳内镜下摘除砧骨体及鼓室成形术治疗局限性上鼓室病变伴鼓膜穿孔30 例疗效分析 |
| Efficacy analysis of 30 cases of localized upper tympanic lesions with tympanic membrane perforation treated by endoscopic removal of the incus body and tympanoplasty |
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| DOI：10.3969/j.issn.1009-6469.2022.09.035 |
| 中文关键词: 中耳炎 鼓室成形术 耳外科手术 内窥镜检查 上鼓室病变 鼓膜穿孔 耳内镜 砧骨体 疗效 |
| 英文关键词: Otitis media Tympanoplasty Otologic surgical procedures Endoscopy Upper tympanic disease Tympanic membrane perforation Otoscope Incus body Efficacy |
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| 中文摘要: |
| 目的探究耳内镜下摘除砧骨体及鼓室成形术治疗局限性上鼓室病变伴鼓膜穿孔的疗效。方法回顾性分析2019年9月至2020年12月在蚌埠医学院第一附属医院收治的60例局限性上鼓室病变伴鼓膜穿孔的病例，根据手术治疗方式分为耳内镜组30例和显微镜组30例。耳内镜组为耳内镜下处理上鼓室病变同时摘除砧骨体及鼓室成形术，显微镜组为传统显微镜鼓室手术。分析两组术前及术中情况，比较两组手术情况、手术前和术后3个月的听力及鼓膜穿孔愈合情况。结果在手术时间、术后24 h视觉模拟评分法(VAS)疼痛程度、术后住院时间的比较中，耳内镜组均要明显优于显微镜组(P<0.05)；术后3个月，耳内镜组临床有效率为96.67%，明显高于显微镜组的73.33%(P<0.05)。两组病人术前平均气导听阈值相比、平均气骨导差值相比，差异无统计学意义(P>0.05)；而两组病人术后平均气导听阈值相比、平均气骨导差值相比较，差异有统计学意义(P<0.05)；且耳内镜组术后平均气导听阈值与平均气骨导差值比术前均降低(P<0.05)。结论耳内镜下摘除砧骨体有利于局限性上鼓室病变的清理及鼓窦和乳突腔引流，更有利于术后鼓膜愈合、提高干耳率及听力恢复。与显微镜手术相比，耳内镜手术创伤小，病人疼痛感轻、住院时间短，值得临床推广应用。 |
| 英文摘要: |
| Objective To investigate the efficacy of endoscopic removal of the incus body and tympanoplasty in the treatment of localized upper tympanic lesions with tympanic membrane perforation.Methods A retrospective analysis was performed of 60 cases of localized upper tympanic lesions with tympanic membrane perforation admitted to the First Affiliated Hospital of Bengbu Medical College from September 2019 to December 2020. According to the surgical treatment methods, they were divided into the otoscope group of 30 cases and a microscope group of 30 cases. In the otoscope group, the upper tympanic lesions were treated by otoscopy, the incus body was removed and tympanoplasty was performed, while the microscope group underwent traditional microscope tympanic surgery. The preoperative and intraoperative conditions of the two groups were analyzed, and the surgical conditions, hearing and tympanic membrane perforation healing before and 3 months after the operation were compared between the two groups.Results In the comparison of operation time, visual analog scale (VAS) pain level at 24 hours after operation, and postoperative hospital stay, the endoscopic ear group was significantly better than the microscope group (P < 0.05); the clinical effective rate of the otoscope group was 96.67% at 3 months after operation, which was significantly higher than 73.33% of microscope group (P < 0.05). There was no significant difference in the preoperative average air conduction hearing threshold and the average air conduction difference between the two groups of patients (P > 0.05), while and the average air conduction hearing threshold and average air-bone conduction difference in the otoscope group after the operation were lower than those before the operation (P < 0.05).Conclusions The removal of the incus body under otoscopic endoscopy is beneficial to the clearance of localized upper tympanic lesions and the drainage of the tympanic sinus and mastoid cavity and is more conducive to postoperative tympanic membrane healing, increased dry ear rate and hearing recovery. Compared with microscope surgery, otoscope surgery has less trauma, less pain, and shorter hospital stay, which is worthy of clinical application. |
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