[Comparison of acellular dermal allograft and tragus cartilage perichondrium in type Ⅰ tympanoplasty under otoendoscopy]

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Dec;34(12):1108-1111. doi: 10.13201/j.issn.2096-7993.2020.12.012.
[Article in Chinese]

Abstract

Objective:To compare the therapeutic effect of otoendoscopic tympanoplasty with acellular dermal allograft(AlloDerm) and tragus cartilage perichondrium. Method:121 patients who underwent type Ⅰ tympanoplasty under otoscope were retrospectively analyzed. According to the grafts used, they were divided into two groups: AlloDerm group (56 cases) and tragus cartilage perichondrium group (65 cases). The operative time, postoperative tympanic membrane healing rate, and hearing recovery were compared between two groups. The follow-up time was twelve months. Result:The operative time in the AlloDerm group were lower than those in the tragus cartilage perichondrium group(P<0.05). The successful closure rates between the acellular dermal allograft group and tragus cartilage perichondrium group at 1-month follow-up were 92.86% and 92.31% respectively, while the closure rates between two groups at 6-month follow-up were drop to 91.07% and 90.77% respectively, the closure rates between two groups at 12-month follow-up were also 91.07% and 90.77% respectively,the was no statistically difference between two groups(P>0.05). The difference in pre-and post-operative air bone gap(ABG) values between two groups was no statistically significant(P>0.05). Conclusion:Both the AlloDerm and the tragus cartilage perichondrium tympanoplasty can achieve satisfactory healing rate of the tympanic membrane and audiologic improvement. However, AlloDerm has a short operation time, no need to obtain materials and less trauma, and is worth of promotion and application.

目的:比较耳内镜下脱细胞异体真皮与耳屏软骨-软骨膜行Ⅰ型鼓室成形术的疗效。 方法:回顾性分析行耳内镜下Ⅰ型鼓室成形术的患者共121例(121耳),按采用的修补材料分为脱细胞异体真皮组(异体真皮组)56例(56耳)和耳屏软骨-软骨膜复合体组(软骨组)65例(65耳)。比较2组手术时间、术后鼓膜愈合率、听力恢复情况。随访12个月。 结果:异体真皮组与软骨组手术时间分别为(59.29±6.48) min和(70.78±7.31) min,2组手术时间比较差异有统计学意义(P<0.05)。术后1个月鼓膜愈合率分别为92.86%、92.31%,术后6个月分别为91.07%、90.77%,术后12个月分别为91.07%、90.77%,2组术后1、6、12个月鼓膜愈合率比较差异均无统计学意义(P>0.05)。2组术后12个月听力恢复情况比较差异无统计学意义(P>0.05)。 结论:耳内镜下采用脱细胞异体真皮及耳屏软骨-软骨膜行Ⅰ型鼓室成形术疗效确切,能提高鼓膜愈合率及改善患者听力效果。前者手术时间短,无需取材创伤小,值得推广应用。.

Keywords: acellular dermal allograft; otoendoscopy; tragus cartilage perichondrium; treatment effectiveness; tympanoplasty.

MeSH terms

  • Allografts
  • Cartilage
  • Humans
  • Myringoplasty
  • Retrospective Studies
  • Treatment Outcome
  • Tympanic Membrane Perforation*
  • Tympanoplasty*