Volume 21 Issue 12
Dec.  2023
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DONG Jianfei, DAI Yanhong, CHEN Jie, ZHOU Han, GAO Xia, LU Ling. Effect of transauricular endoscopic tympanoplasty in the treatment of large tympanic membrane perforation[J]. Chinese Journal of General Practice, 2023, 21(12): 2014-2017. doi: 10.16766/j.cnki.issn.1674-4152.003279
Citation: DONG Jianfei, DAI Yanhong, CHEN Jie, ZHOU Han, GAO Xia, LU Ling. Effect of transauricular endoscopic tympanoplasty in the treatment of large tympanic membrane perforation[J]. Chinese Journal of General Practice, 2023, 21(12): 2014-2017. doi: 10.16766/j.cnki.issn.1674-4152.003279

Effect of transauricular endoscopic tympanoplasty in the treatment of large tympanic membrane perforation

doi: 10.16766/j.cnki.issn.1674-4152.003279
Funds:

 82071059

 YKK20069

  • Received Date: 2023-03-04
  •   Objective  To investigate the clinical effect of underlay (medial) tympanoplasty of "external auditory canal flap-tympanic annulus-residual tympanic membrane 360 degree full lift" under oto-endoscope for the treatment of large tympanic membrane perforation, and to introduce the key points and techniques of clinical surgery.  Methods  Thirty patients (30 ears) with large tympanic membrane perforation who underwent tympanoplasty at Nanjing Drum Tower Hospital from July 2019 to December 2021 were selected. They were divided into groups according to the type of surgery. In the observation group, 15 patients (15 ears) underwent tympanoplasty by underlay (medial) tympanoplasty after the external auditory canal flap, drum ring and residual tympanic membrane were completely opened under oto-endoscope. In the control group, 15 cases (15 ears) underwent underlay (medial) tympanoplasty after 270-degree elevation of the external auditory canal posterior wall flap, tympanic ring and residual tympanic membrane under oto-endoscope. Postoperative follow-up was conducted for 6 months, and operative time, blood loss, tympanic healing and postoperative hearing were compared between the two groups.  Results  The mean operating times of the observation group and the control group were (108.33±8.28) min and (111.00±12.96) min, respectively, with no statistical significance. The mean blood loss were (13.00±3.00) mL and (12.07±3.31) mL, respectively, and the difference was not statistically significant. The success rate of tympanic membrane repair at 6 months was 100.00% (15/15) in the observation group and 86.67% (13/15) in the control group. There were 12 cases (80.00%) of hearing improvement in the observation group and 9 cases (60.00%) in the control group, however, the difference was not statistically significant (P>0.05).  Conclusion  Compared to conventional tympanoplasty with underlay (medial) tympanoplasty after 270 degrees of external ear canal flap, tympanic annulus and residual tympanic membrane under oto-endoscope, tympanoplasty with underlay (medial) tympanoplasty after 360 degrees of full flap, tympanic annulus and residual tympanic membrane and residual tympanoplasty under oto-endoscope has the same advantages in the treatment of large tympanic membrane perforation, but it can improve the success rate of repair and postoperative hearing of patients.

     

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