Clinical Research of Tragus Cartilage-Perichondrium Composite Graft Under Endoscope on Treatment of Tympanic Membrane Perforation
Zhang Wen1,Yang Qimei2
Department of Otorhinolarynology , Shaanxi Provincial People’s Hospital，xi’an 710068, People’s Republic of China
Objective: The work was planned to compare the graft acceptance rates and auditory outcomes of tragal cartilage-perichondrium myringoplasty operations using endoscope (endoscopic group) with those of temporalis fascia myringoplasty under microscope（microscopic group）in a homogenous group of patients.
Methods: Data from 460 patients (460 ears) who were received the myringoplasty in our department between January 2011 and December 2014 were reviewed, including 242 patients (242 ears) with endoscopic group and 218 patients (218 ears) with microscopic group. Operation time,blood loss,grafts acceptance rates and pre- and post- (one month,three-six months and one-tow years) operative audiograms were compared.
Results: The mean operative time and blood loss of endoscopic group were (43.5±14.2) min and（5.2±1.8）ml, compared with （84.0±13.5）min and （15.0±4.1）ml microscopic group（ t=-6.55, P<0.01； t=-12.14, P<0.01）.Graft acceptance rates were achieved in 228 patients (94.21%) in the endoscopic group and in 200 patients (91.74%) in the microscopic group after one month operation. After one-two years of follow-up, grafts acceptance rates in tow groups were 92.15% and 89.45%.This differences were not statistically significant (P>0.05). Comparison of the increases in mean air conduction threshold and the air–bone gaps post-operatively between both groups showed no statistically significant(P>0.05).
Conclusion: The tragal cartilage-perichondrium myringoplasty operations using endoscope have a good clinical efficacy, so it is worthy of a certain range of clinical application.