The Feasibility and Treatment Results of Transcanal Endoscopic Myringoplasty
The Feasibility and Treatment Results of Transcanal Endoscopic Myringoplasty
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DOI：
10.1097/mao.0000000000003551
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发表时间：
2022-07-01
影响因子：
2.1
通讯作者：
Kakehata, Seiji
中科院分区：
文献类型：
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作者：
Furukawa, Takatoshi;Ito, Tsukasa;Kakehata, Seiji
目的初步报道2014年经鼻内镜鼻膜成形术25例。现在我们的经鼻内镜鼻膜成形术数量达到209耳，这使我们能够充分调查鼻膜成形术的可见性、必要性、治疗结果和多因素分析。研究设计前瞻性病例系列。三级转诊中心设置。2011年至2019年，201例患者共209耳行经鼻内镜下耳膜成形术，随访1年以上。方法对同一例患者术前内镜与镜下表现进行比较。我们根据手术类型、穿孔大小、手术侧面、性别、穿孔原因、年龄检查术后1年的成功率，并检查听力结果。采用Logistic回归分析，探讨穿孔闭合相关患者的基本人口学特征和临床特征。结果14.4%的患者术前镜下未见穿孔前缘。相比之下，内窥镜显示整个鼓膜在一个领域。然而，由于操作困难，2.4%的鼓室手术需要管成形术。射孔闭合率为90.4%。Logistic回归分析显示，年龄bbbb11是唯一与穿孔闭合相关的显著因素。气骨间隙平均减少12.1 dB。结论内镜下鼓膜成形术与传统显微技术相比具有更好的显像性，相同或更好的闭合率，相同或更低的并发症发生率。
Objective We reported on transcanal endoscopic myringoplasty in 25 cases preliminarily in 2014. Now our number of transcanal endoscopic myringoplasty reached to 209 ears and allowed us to adequately investigate the visibility, necessity of canalplasty, treatment results, and multivariate analysis. Study Design A prospective case series. Setting Tertiary referral center. Patients Transcanal endoscopic myringoplasty was performed on 209 ears in 201 patients between 2011 and 2019 and followed up over 1 year. Methods Preoperative endoscopic and microscopic views for the same patient were compared. We examined success rates at 1 year after surgery according to operation type, perforation size, operation side, gender, cause of perforation, and age, and also examined hearing results. Logistic regression analysis was performed to investigate the basic demographic and clinical characteristics of the patients associated with perforation closure. Results The anterior edge of the preoperative perforation was not visible under microscopy in 14.4% of patients. In contrast, endoscopic views revealed the entire tympanic membrane in one field. However, canalplasty was required in 2.4% of tympanic procedures due to difficulty of manipulation. The overall closure rate for perforations was 90.4%. Logistic regression analysis revealed that age > 11 was the only significant factor associated with perforation closure. The average reduction in air-bone gap was 12.1 dB. Conclusion The endoscopic myringoplasty produced better visualization, the same or better closure rates, and the same or lower complication rates as compared with traditional microscopic techniques.