Clinical Study On The Application Of Otolaroscopy In Middle Ear Surgery

Objective To analyze and compare the effect of three cartilage techniques under otoendoscopy in the repair of tympanic membrane perforation and the effect of otoendoscopy in the treatment of upper tympanic cholesteatoma.Method Sixty-seven ears(67 ears)with tympanic membrane perforation and six cases(6 ears)with superior tympanic cholesteatoma were prospectively enrolled.Sixty-seven ears with tympanic membrane perforation were randomly divided into full-thickness cartilage-perichondrium group(20 ears),island cartilage-monolayer soft membrane group(24 ears)and island cartilage-bilayer soft membrane group(23 ears).The operation difficulty of tympanic membrane repair,the observation of middle ear cavity during operation,the tympanic membrane healing and hearing recovery at 8 months after operation were compared and analyzed.The observation of middle ear cavity and the healing of tympanic membrane and hearing recovery at 8 months after operation were compared and analyzed.Results Perforation of the tympanic membrane 67 ears: The process of laying the graft in the full-thick cartilage-perichondrium group is relatively easy compared with the island-like cartilage-single-layer soft membrane group and the island-like cartilagedouble-layer soft tympanic membrane group.In addition to 4 patients who were lost to follow-up,only one patient with island-like cartilage-single-layer soft membrane group had postoperative tympanic membrane perforation at 8 months,and the rest of the patients had good tympanic membrane healing.The postoperative hearing of the three groups of patients was significantly improved,and the difference was significant compared with the preoperative.There was no significant difference in postoperative hearing improvement between the three groups.Endoscopic tympanic cholesteatoma treatment of 6 ears: the tympanic membrane was well healed,postoperative hearing was significantly improved compared with preoperative,and the difference was significant compared with preoperative.Under the endoscope,the structures of the eustachian tube,the ossicular chain and the upper tympanic cavity can be clearly observed.Conclusion Three kinds of Tragus Cartilage technique under otoscope can achieve good tympanic healing and hearing improvement after tympanic membrane repair,but the full thickness cartilage-monolayer cartilage technique is superior to the other two cartilage techniques in operation difficulty and operation time.Observation of the removal of middle ear cavity by otoendoscopy and hearing recovery after removal of upper tympanic cholesteatoma by otoendoscopy were good without obvious recurrence.