Split-Thickness Cartilage Graft Combined With Perichondrium for Endoscopic Repair of Total and Subtotal Drum Perforations.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Ahmed Mohammed Abdelghany, Hossam Abdelhay Gadulhaq
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引用次数: 0

Abstract

Objective: This study aims to describe our new modification to cartilage tympanoplasty for endoscopic repair of total and subtotal tympanic membrane perforations and evaluate its outcomes.

Study design: Retrospective case series.

Setting: Multiple institutions.

Methods: The study was conducted using records of patients who underwent tympanoplasty for subtotal and total perforations from January 2018 to June 2022. Utilizing an endoscopic transcanal approach, we employed a double graft consisting of outer tragal perichondrium supported by inner split-thickness tragal cartilage as separate layers, both placed in an underlay fashion lateral to the malleus, without the need to elevate a tympanomeatal flap. Anatomical success was defined as complete primary closure of the perforation, while functional success was defined as achieving an air-bone gap of ≤20 dB at 12 months postoperative.

Results: The series involved 64 patients, predominantly males (53%). The mean age was 30.8 years. 56.3% of patients had subtotal perforations. The anatomical success rate was 90.6% while the functional success rate was 87.5%. Postoperative speech discrimination scores significantly increased in all patients.

Conclusion: Our modification provides effective anatomical and audiological outcomes. This technique reliably resists graft displacement and shrinkage before adequate healing. It avoids problems of elevating tympanomeatal flaps with comparable results to traditional approaches.

内窥镜修复全鼓膜穿孔和鼓膜次全穿孔的分层厚度软骨移植与软骨周围相结合。
研究目的本研究旨在描述我们对软骨鼓室成形术的新改良,用于鼓膜全穿孔和次全穿孔的内窥镜修复,并评估其效果:研究设计:回顾性病例系列:研究设计:回顾性病例系列:研究使用2018年1月至2022年6月期间接受鼓膜次全穿孔和全穿孔手术的患者记录。利用内窥镜经耳道方法,我们采用了双层移植物,包括外侧耳廓软骨和内侧分层耳廓软骨,两者均以垫底方式置于耳郭外侧,无需抬高鼓膜瓣。解剖学上的成功是指穿孔完全闭合,而功能上的成功是指术后12个月气骨间隙≤20 dB:该系列共有 64 名患者,其中男性占多数(53%)。平均年龄为 30.8 岁。56.3%的患者为次全穿孔。解剖成功率为 90.6%,功能成功率为 87.5%。所有患者的术后语言辨别力评分均有明显提高:结论:我们的改良技术可提供有效的解剖和听力效果。结论:我们的改良技术能提供有效的解剖和听力效果。这种技术能可靠地防止移植物在充分愈合前移位和萎缩。它避免了抬高鼓膜瓣的问题,效果与传统方法相当。
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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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