耳内镜下使用人脱细胞异体真皮修补鼓膜的临床疗效

Clinical effect of otoendoscopic repair of tympanic membrane perforation using human-derived acellular dermal matrix

摘要:

目的观察并讨论在耳内镜下使用人脱细胞异体真皮修补鼓膜的移植成功率和术后听力增益。方法收集2023年11月—2024年1月行耳内镜下使用人脱细胞异体真皮修补鼓膜患者28例，观察患者术后鼓膜穿孔愈合及听力改善情况。术前所有患者均行乳突高分辨率CT扫描、耳内镜检查、纯音听阈测试及其他相关检查。术后0.5、1、3个月定期随访复查，耳内镜下观察患者鼓膜穿孔的愈合情况，纯音测听评估听力；并采用SPSS 27.0软件进行统计学分析。结果术后3个月复查，移植成功率达到93%(26/28)。术前气导听力(41.61±9.40) dB HL明显大于术后3个月(28.75±5.68) dB HL (t=3.09,P=0.009)。结论耳内镜下使用人脱细胞异体真皮修补鼓膜穿孔是一种可靠的治疗方法，愈合率高、并发症少，听力恢复可。

Abstract:

Objective To evaluate the graft success rate and postoperative hearing gain for repair of tympanic membrane perforation using human-derived acellular dermal matrix under otoendoscope. Methods A total of 28 patients who had received otoendoscopic myringoplasty with human-derived acellular dermal matrix in our department from November 2023 to January 2024 were included. The healing of perforated tympanic membrane and the improvement of hearing were observed. Preoperative high-resolution computed tomography of temporal bone, otoendoscopy, pure tone audiometry and other routine examinations were performed. At half a month, one month and three months after the surgery, the healing of tympanic membrane perforation was observed under otoendoscope, and the hearing was evaluated by pure tone audiometry. SPSS 27.0 software was used for statistical analysis. Results Three months after surgery, the graft success rate achieved 93% (26/28). The preoperative air conduction hearing [(41.61± 9.40)dB HL] was significantly higher than that at 3 months after surgery [(28.75±5.68) dB HL] (t=3.09, P=0.009). Conclusion The application of human-derived acellular dermal matrix under otoendoscope to repair tympanic membrane perforation is a reliable treatment with high healing rate, few complications and good hearing recovery.