目的：测量耳屏软骨-软骨膜复合体厚度，探讨其对中耳炎手术治疗效果及重建听力的影响。方法49例（50耳）慢性中耳炎患者根据病情行伴或不伴乳突根治的鼓室成形术，均以耳屏软骨-软骨膜复合体修补鼓膜，术中测量耳屏软骨-软骨膜复合体厚度，术后每周随访一次至干耳，术后半年复查纯音听阈，分析耳屏软骨-软骨膜复合体厚度、干耳与否、干耳时间、鼓膜生长情况、术前和术后半年0．5、1．0、2．0、3．0kHz频率的纯音听阈。结果50耳耳屏软骨-软骨膜复合体的平均厚度为0．87±0．08mm（0．72～1．07mm），干耳时间3～12w ，中位数3 w ；42耳术后随访半年，鼓膜形态、色泽良好；其中31耳患耳气骨导差缩小，听力提高，另11耳听力结果未纳入分析。结论耳屏软骨-软骨膜复合体的厚度较恒定，作为修复中耳材料具有干耳时间较短、利于听力改善、并发症较少等特点。%Objective By measuring the thickness of tragus cartilage -perichondrium complex in 50 ears ,to evaluate the feasibility and efficacy of practical application with tragus cartilage -perichondrium complex in the tym-panoplasty based on a clinical tria1 .Methods A retrospective study was carried out among 50 ears with chronic oti-tis media ,treated in our hospital by a surgical procedure with tragus cartilage -perichondrium complex used in the tympanoplasty .The thickness of tragus cartilage -perichondrium complex was mearured during operation .Postoper-ative following -up was completed once a week to ear -drying .The pure tone audiometry(PTA) was reexamined at half a year after operation .The observations included the thickness of tragus cartilage -perichondrium comple ,the dry status ,drying time of tympanic membrane ,and the preoperative and half a year postoperative PT A .Results The average thickness of tragus cartilage-perichondrium complex in the 50 ears was 0 .87 ± 0 .08 mm(0 .72~1 .07 mm) . The cartilage perichondrium composite graft was applied in the tympanoplasty while the median of drying ear time was 3 weeks in 50 ears .The average air-bone gaps of pure tone audiometry (PTA -ABG) of 0 .5 ,1 .0 ,2 .0 ,3 .0 kHz decreased at half a year after the operation .The colors and forms of the tympanic membrane were satisfactory except the attic lateral wall and the posterior wall of the external auditory canal had collapsed in one ear .Conclusion The thickness of tragus cartilage-perichondrium complex is stable ,can be used in the tympanoplasty with obvious benefits .
展开▼
