The Clinical Application Of Tragus Cartilage-perichondrium Complex With Empty Tympanum In Myringoplasty With Otic Endoscope

Objective: In this paper,a retrospective study of myringoplasty was carried out,to explore the feasibility of tragus cartilage-perichondrium complex with empty tympanum in myringoplasty with otic Endoscope.It provides clinical data and theoretical basis for the popularization and operation of the technology.Methods:Collecting 66 cases(aged from 20 to 69 years old,average 49.58±12.41 years old,male 31 cases,female 35 cases),which were diagnosed as tympanic membrane perforation and treated in Otolaryngology Head and neck surgery department of the central hospital of dalian,during from May 2016 to May 2017.Among them,64 cases were chronic suppurative otitis media perforation,and 2 cases were traumatic tympanic membrane perforation.All patients after ear CT examination,acoustical impedance and pure tone audiometry test.Among them,26(male 12 cases,female 14cases)patients were selected under the microscope.Another 40(male 19 cases,female21 cases)people chose under the ear endoscope.We divided them into two big groups and two small groups,group 1: us tragus cartilage-perichondrium complex with empty tympanum in myringoplasty with otic Endoscope(endoscopic group).The first group was divided into two groups,the A and the B.In group A,there is no need to fill gelatin sponge for tympanum in myringoplasty,Group B was filled with gelatin sponge granules in myringoplasty.group two : temporalis fascia myringoplasty under microscope(microscopic group).Operation time,blood loss,postoperative pain,hospitalstay and grafts acceptance rates of past(one month,three-six months)were compared.Preoperative and postoperative pure-tone hearing threshold was recorded and compared to evaluate the efficacy of stapedotomy after six months.Bone conduction(BC)gas conduction(AC)is the threshold average of 0.5khz,1KHz and 2KHz frequencies respectively.Preoperative and postoperative ABG was the difference between preoperative or postoperative bone conduction(BC)and air conduction(AC).Results:There were significant differences in the time of operation time,blood loss,postoperative pain,and hospital stay between the endoscopic group and microscopic group(P<0.05).The endoscopy group has the advantages of short operative time,less blood loss,mild postoperative pain and quick recovery.There was no significant difference between the endoscopy group and the microscopy group in the grafts acceptance rates(P > 0.05).The tragal cartilage-perichondrium myringoplasty operations using endoscope have a good clinical efficacy.In the meantime,there was no significant difference between the group A and B in the blood loss,postoperative pain,and hospital stay and grafts acceptance rates(P>0.05).Therefore,there is no need to fill the gelatin sponge in the tympanum.Conclusion:First:There was no significant difference between the endoscopy group and the microscopy group in the grafts acceptance rates(P>0.05).It is an effective and safe operation method.Second:the endoscopy group has the advantages of short operative time,less blood loss,mild postoperative pain and quick recovery.so it is worthy of a certain range of clinical application.Third:Myringoplasty with tragus cartilage-perichondrium complex need not to fill the gelatin sponge in the tympanum...