Clinical Research Of Myringoplasty With Different Materials Under Endoscope

Objective:To investigate the clinical efficacy and safety of myringoplasty with different materials(tragal perichondrium,tragal cartilage-perichondrium complex)under endoscope,in order to find a more effective and practical tympanic membrane repair material and method,which provides a reliable theoretical basis for clinical myringoplasty.Methods:Retrospective analysis of 100 patients with chronic suppurative otitis media or traumatic tympanic membrane perforation with simple myringoplasty in the Department of Otolaryngology Head and Neck Surgery of Shaanxi Provincial people's Hospital from September 2016 to February 2018.They were randomly divided into experimental group and control group.There was no significant difference in general condition between the two groups(P>0.05).The experimental group and the control group were treated with tragal cartilage-perichondrium complex and tragal perichondrium under endoscope,respectively.The tympanic membrane healing and hearing recovery were observed at 1 month,3 months,6 months and 12 months after operation.Results:1.Tympanic membrane healing and complications:(1)At 1 month,3 months,6 months and 12 months after operation,the healing rates of tympanic membranes in the experimental group were 100%,98%,96%,94% respectively,and those in the control group were 100%,96%,92%,88%,respectively.Both groups achieved better tympanic membrane healing rates.There was no significant difference between them(P>0.05).(2)At 12 months after operation,the incidence of complications in the experimental group and the control group were 6% and 12%,respectively,and there was no significant difference between the two groups(P>0.05).2.Hearing recovery:(1)1 month,3 months,6 months and 12 months after operation,the results of PTA and ABG in the two groups were significantly improved compared with those before operation,and the difference was statistically significant(P<0.05).(2)There was no significant difference in the results of PTA and ABG between the experimental group and the control group at 1 month,3 months,6 months,12 months after operation(P>0.05),and there was no significant difference between the two groups in the results of postoperative hearing recovery.(3)The results of early postoperative hearing in the controlgroup were slightly better than those in the experimental group,but from about 6 months after operation,there was no difference between the two groups,and the hearing results of the two groups gradually tended to be stable in the 6 months after operation.(4)The results of PTA and ABG in the experimental group were significantly different at 1 month,3months,6 months and 12 months after operation(P<0.05).1 month,3 months,6 months and 12 months after operation in the control group,there were significant differences in the results of PTA and ABG(P<0.05).The hearing of the two groups recovered well after operation.3.Comparison of the effect of postoperative hearing recovery between the two groups:At 12 months after operation,the total effective rate of hearing recovery in the experimental group and the control group was 90% and 86%,respectively.Both groups achieved satisfactory hearing recovery results,and there was no statistically significant difference between the two groups(P>0.05).The excellent rate and total effective rate of the experimental group were slightly higher than those of the control group at 12 months after operation.Conclusion:1.Both myringoplasty with tragal cartilage-perichondrium complex and tragal perichondriumunder endoscope can achieve satisfactory tympanic membrane healing rate,and good hearing recovery after operation.2.The tragal perichondrium and the tragal cartilage-perichondrium complex are effective,practical and reliable materials for the repair of the tympanic membrane.It is a safe and effective method to repair tympanic membrane by using tragal perichondrium or tragal cartilage-perichondrium complex under endoscope.And the tragal cartilageperichondrium complex is the optimal material for repairing the large perforation of the tympanic membrane.