Surgical Outcomes of Endoscopic Transtympanic Myringoplasty Versus Over-Underlay Tympanoplasty Type I Versus Overlay Tympanoplasty Type I for Tympanic Membrane Perforations.

IF 1.9 3区 医学 Q3 CLINICAL NEUROLOGY
Pornsek Tananuchittikul, Nithita Sattaratpaijit
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引用次数: 0

Abstract

Objective: To compare the surgical outcomes of endoscopic transtympanic myringoplasty versus endoscopic over-underlay tympanoplasty versus endoscopic overlay tympanoplasty.

Study design: Retrospective chart review.

Setting: Tertiary referral university hospital.

Patients: Adult subjects with first diagnosed dry tympanic membrane perforation for at least 3 months who underwent endoscopic tympanoplasty between September 2021 and January 2024.

Intervention: Endoscopic transtympanic myringoplasty (ETM), endoscopic over-underlay tympanoplasty (EDT), and endoscopic overlay tympanoplasty (EVT).

Main outcome measures: The primary outcome was graft success rate at 6 months after surgery. Secondary outcomes were audiologic data including preoperative and postoperative pure-tone air average, pure-tone bone average, and air-bone gap (ABG).

Results: A total of 82 endoscopic tympanoplasty cases were included: 25 in ETM, 30 in EDT, and 27 in EVT. The overall graft success rate was 93.9%. The graft success rates were not different between the three groups: 92.0% in the ETM group versus 93.3% in the EDT group versus 96.3% in the EVT group (p = 0.860). Pure-tone air average improved significantly after surgery in all groups, and hearing gains for ETM, EDT and EVT were 7.9 ± 6.5, 11.3 ± 7.3, and 10.8 ± 6.2 dB, respectively, which were comparable (p = 0.141).

Conclusions: Favorable graft success rates and audiologic outcomes were obtained in all groups. The ETM method is more suitable for medium-sized tympanic membrane (TM) perforations because it is easier to perform and minimally invasive. For large TM perforations, we suggest the EDT or the EVT method, depending on perforation size, location, and preoperative ABG.

内镜下经鼓膜鼓膜成形术与I型覆盖下鼓膜成形术对比I型覆盖鼓膜成形术治疗鼓膜穿孔的手术效果
目的:比较内镜下经鼓室鼓膜成形术与内镜下覆盖鼓室成形术和内镜下覆盖鼓室成形术的手术效果。研究设计:回顾性图表回顾。单位:三级转诊大学医院。患者:首次诊断为干性鼓膜穿孔至少3个月的成人受试者,于2021年9月至2024年1月期间接受内窥镜鼓室成形术。干预:内镜下经鼓膜成形术(ETM),内镜下覆盖鼓室成形术(EDT),内镜下覆盖鼓室成形术(EVT)。主要观察指标:主要观察术后6个月移植成功率。次要结果是听力学数据,包括术前和术后纯音空气平均、纯音骨平均和气骨间隙(ABG)。结果:共纳入内镜下鼓室成形术82例,其中ETM 25例,EDT 30例,EVT 27例。总移植成功率为93.9%。三组间移植物成功率无差异:ETM组92.0%,EDT组93.3%,EVT组96.3% (p = 0.860)。各组术后纯音空气平均均有明显改善,ETM、EDT、EVT的听力增益分别为7.9±6.5、11.3±7.3、10.8±6.2 dB,具有可比性(p = 0.141)。结论:两组移植成功率及听力学指标均较好。ETM方法更适合于中等大小的鼓膜穿孔(TM),因为它更容易操作和微创。对于较大的TM射孔,根据射孔大小、位置和术前ABG,我们建议采用EDT或EVT方法。
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来源期刊
Otology & Neurotology
Otology & Neurotology 医学-耳鼻喉科学
CiteScore
3.80
自引率
14.30%
发文量
509
审稿时长
3-6 weeks
期刊介绍: ​​​​​Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.
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