湿耳与干耳条件下行Ⅰ型鼓室成形术后鼓膜愈合率的差异及鼓膜残缘的病理特点

Comparison of type I tympanoplasty efficacy and histopathological characteristics to the tympanic membrane in dry and wet ear

摘要:

目的比较湿耳与干耳两种条件下行Ⅰ型鼓室成形术后鼓膜愈合率的差异，以及两种状态下鼓膜残缘的病理特点。方法将2017年1月—2018年12月就诊、需要行Ⅰ型鼓室成形术的慢性化脓性中耳炎患者纳入研究。术前由两名耳科医师根据纳入及排除标准独立判定鼓膜的干、湿状态。最终纳入研究对象82例，其中试验组（湿耳）31例，对照组（干耳）51例。比较两组术中鼓膜残缘的病理图像及术后3个月两组的鼓膜愈合率。结果试验组鼓膜完全愈合患者29例（93.5%），对照组鼓膜完全愈合患者48例（94.1%），两组鼓膜愈合率差异无统计学意义（P>0.05），试验组鼓膜残缘拥有更多扩张的毛细血管及炎性细胞的浸润。结论慢性化脓性中耳炎患者可以尝试在湿耳状态下行Ⅰ型鼓室成形术，湿耳状态下鼓膜残缘毛细血管扩张及炎性细胞浸润明显，有利于鼓膜的愈合。

Abstract:

ObjectiveTo compare the differences of type I tympanoplasty efficacy and the histopathological characteristics to the tympanic membrane in dry and wet ear. MethodsPatients with chronic suppurative otitis media admitted from January 2017 to December 2018 were included in the study,who needed type I tympanoplasty. Before operation, the dry and wet status of tympanic membrane was independently determined by two otologists according to inclusion and exclusion criteria. Finally, a total of 82 cases were included in the study. There were 31 cases of wet ears in the experimental group, and 51 cases of dry ears in the control group. To compare the differences of the pathological characteristics of eardrum remnant and the tympanic healing rate of type I tympanoplasty in wet and dry ears at three months postoperation.ResultsThe tympanic healing rate in wet ear group and dry ear group were 29 cases (93.5%) and 48 cases (94.1%) respectively. There was no significant difference in the healing rate of tympanic membrane between the two groups（P>0.05）. There were more dilated capillaries and infiltration of inflammatory cells in the remnant of tympanic membrane in the wet ear group compared to the dry ear group.ConclusionsPatients with chronic suppurative otitis media may be performed an operation of type I tympanoplasty under wet ear condition. There are more dilated capillaries and inflammatory cells infiltrated the remnant of the wet ears tympanic membrane.