蝶形软骨嵌入技术修复小至大型鼓膜穿孔。
Butterfly Cartilage Inlay Technique for Repairing Small to Large Tympanic Membrane Perforations.
文献信息
| PMID | 42948288 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ji Min Yun |
| 作者单位 | Department of Otorhinolaryngology-Head and Neck Surgery Chung-Ang University College of Medicine Seoul Republic of Korea. |
| 期刊 | Laryngoscope investigative otolaryngology |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 本研究比较了蝶形软骨嵌入鼓室成形术治疗小型与中大型鼓膜（TM）穿孔的解剖学和功能学结果。
方法： 我们回顾性评估了2017年至2023年间接受蝶形软骨嵌入鼓室成形术的50例患者（50耳）。使用ImageJ定量测量穿孔大小，并分为小型（<20%，n=28）和中大型（≥20%，n=22）组。评估了移植物成功率、手术时间、并发症以及术前和术后听力阈值。
结果： 小型组和中大型组的移植物成功率均较高且相当（92.9% vs. 86.4%；p=0.643），中位手术时间也相当（32.0 vs. 30.5分钟；p=0.531）。两组术后气骨导差（ABG）均显著降低（p<0.001）。中大型组的ABG改善（ΔABG）显著大于小型组（-7.5 dB vs. 0 dB；p=0.002）。穿孔大小与ΔABG呈负相关（r=-0.403，p=0.003），但与手术时间无关（p=0.31）。
结论： 蝶形软骨嵌入技术对小型和中大型TM穿孔均实现了高移植物成功率和良好的功能学结果。无论穿孔大小如何，该技术在局部麻醉下均保持手术高效性和可行性。
证据等级： 3。
英文摘要
OBJECTIVE: This study compared the anatomical and functional outcomes of butterfly cartilage inlay tympanoplasty between small and medium-to-large tympanic membrane (TM) perforations.
METHODS: We retrospectively evaluated 50 patients (50 ears) who underwent butterfly cartilage inlay tympanoplasty between 2017 and 2023. Perforation sizes were quantitatively measured using ImageJ and categorized into small (< 20%, n = 28) and medium-to-large-sized (≥ 20%, n = 22) groups. Graft success, operative time, complications, and preoperative and postoperative hearing thresholds were evaluated.
RESULTS: The graft success rate was high and comparable between the small and medium-to-large groups (92.9% vs. 86.4%; p = 0.643), as was the median operative time (32.0 vs. 30.5 min; p = 0.531). Both groups achieved significant postoperative reductions in the air-bone gap (ABG) (p < 0.001). The medium-to-large group demonstrated a significantly greater improvement in ABG (ΔABG) than the small group (-7.5 dB vs. 0 dB; p = 0.002). Perforation size was negatively correlated with ΔABG (r = -0.403, p = 0.003) but not with operative time (p = 0.31).
CONCLUSION: The butterfly cartilage inlay technique achieved high graft success and favorable functional outcomes for both small and medium-to-large TM perforations. It remained surgically efficient and feasible under local anesthesia, regardless of perforation size.
LEVEL OF EVIDENCE: 3.