| Objective:By comparing the two techniques(the palisade cartilage perichondrium complex and pure cartilage perichondrium complex),in research on artificial ossicular chain reconstruction of postoperative clinical curative effect,to explore a technique for cartilage palisade tympanic membrane hearing results after reconstruction of the hearing,healing rate,dry ear rate,displacement or extusion of artificial bone and rejection after hearing reconstruction.Method:From October 2011 to December 2016,46 cases(ears)of artificial ossicular chain reconstruction in Department of ENT of Affiliated Hospital of Yan'an University were selected.They were randomly divided into experimental and control groups according to the odd and even sequence.The palisade cartilage perichondrium complex was used in the experimental group and the control group was a simple cartilage perichondrium complex.The experimental group of 21 patients(ear),of which 10 were male,11 were female,mean age 49.52 + 11.50 years old,left ear in 13 cases(61.9%),8 cases of right ear(38.1%),15 ears(71.43%)perforation,perforation in 4 ears(19.05%),2 ears(9.52%)small perforation,simple 6 cases of chronic suppurative otitis media,5 cases of middle ear cholesteatoma,both with 10 cases.The control group of 25 cases(ears),there were 16 males and 9 females,mean age 43.08 + 18.08 years old,left ear in 13 cases(52%),12 cases of right ear(48%),20 ears(80% large perforation),perforation in 4 ears(16%),1 ears(4%)small perforation,only 6 cases of chronic suppurative otitis media with cholesteatoma,6 cases,13 cases of the merger of the two.All were single ear disease.Two groups of patients were operated by the same surgeon and assistant with complete.Collect and record all the patients before and one month,three months,six months after surgery,the average hearing threshold of ear endoscopy(500,1000,2000,4000Hz),ABG(mean 500,1000,2000,4000Hz),while recording the dry ear and tympanic membrane healing after operation,displacement or extusion of artificial bone and rejection after hearing reconstruction.The clinical effect of the two groups of patients after operation was compared.Result:1.Patients in two groups before and one month after surgery,To compare the average hearing threshold and air-bone gap,were P > 0.05,that there was no statistical significance between each group;patients in each group were compared before and one month after surgery,the average hearing threshold and air-bone gap,both were P < 0.05,that the difference was statistically significant.It is suggested that the two groups of patients have improved their preoperative hearing after one month.2.Patients in two groups before and three months after surgery,To compare the average hearing threshold and air bone gap,were P > 0.05,that there was no significant difference between each group;patients in each group were compared before and three months after surgery,the average hearing threshold and air bone gap,both P < 0.05,that the difference was statistically significant.It was suggested that the two groups of patients had improved hearing compared with preoperative hearing after three months.3.Patients in two groups before and six months after surgery,To compare the average hearing threshold and air bone gap,both P < 0.05,that the difference was statistically significant;patients in each group were compared before and six months after surgery,the average hearing threshold and air bone gap,both P < 0.05,that there was statistically significant difference.It was suggested that the two groups of patients had better hearing before surgery than six months after surgery,and that the experimental group had significantly better hearing results after six months than the control group.4.Two groups of patients with perforation of tympanic membrane were healed at 2 weeks after 2 weeks,with a healing rate of 95.65%(44/46).The healing rate of tympanic membrane perforation in the experimental group was 95.24%(20/21),and the healing rate of the tympanic membrane in the control group was 96%(24/25).The comparison of the healing rate of the tympanic membrane in the two groups of patients after operation was tested by statistical test: P > 0.05,and the statistical difference was not statistically significant.5.In the two groups,there were 43 cases of dry ear one month after surgery,the dry ear time was 24-48 days,the average time was 36.6 days,and the dry ear rate was 93.48%(43/46).The dry ear rate of the experimental group was 95.24%(20/21),and the dry ear rate of the control group was 92%(23/25).The comparison of dry ear rate in the two groups one month after surgery was tested by statistical test: P > 0.05,the statistical difference was not statistically significant.6.In both groups,there was no displacement or extusion of artificial bone after surgery and during follow-up from one to six months.No rejection was observed.Conclusion:1.Using the palisade cartilage perichondrium complex or simple cartilage perichondrium complex can improve hearing one month,three months after surgery.There is no significant difference between the two methods in improving postoperative hearing.2.By the palisade cartilage perichondrium complex or simple cartilage perichondrium complex can improve postoperative hearing six months after surgery,with the palisade technology group of patients after six months hearing improvement is better than the simple cartilage perichondrium complex group of patients,is the ideal choice to improve the long-term postoperative hearing results.4.The palisade cartilage perichondrium complex can effectively improve the healing rate of tympanic membrane perforation and dry ear rate after the tympanoplasty. |
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