ZHANG Lu,ZHANG Xiangbao,YANG Huanhuan, et al. Clinical effect of endoscopic inlay butterfly cartilage and underlay tragus perichondriummyringoplasty for moderate tympanic membrane perforation[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(1): 14-19.
Abstract：Objective: To investigate the clinical effect of inlay butterfly cartilage and underlay tragus perichondriummyringoplasty on moderate tympanic membrane perforation under endoscope and the differences
between them. Methods: The clinical data of patients from the department of Otolaryngology of Ningbo No.2 Hospital with moderate tympanic membrane perforation form June to December 2021, who underwent endoscopic tympanoplasty without tympanomeatal flap elevation, were retrospectively analyzed. According to the operation method, the patients were dividedinto two groups: the observation group used inlay butterfly cartilage myringoplasty,and the control group used underlay tragus perichondrium myringoplasty. The two groups were followed up regularly at 6, 12 and 18 months postoperatively, with otoscopy and pure tone audiometry (PTA) performed. The graft success rate, hearing outcomes, complications, ear fullness and operation time were compared between the two groups.Results: Of 56 cases included in the study, 32 cases were in the observation group and 24 cases in the control group. There was no significant difference in sex, age, cause and location of tympanic membrane perforation,calcified spot and dry and wet ears between the two groups (P>0.05). The graft success rate in both groups was 100.00% at 6 and 12 months postoperatively. At 18 months postoperatively, graft success rate was 93.75%(30/32) in the observation group and 91.67% (22/24) in the control group. There was no significant difference between two groups (P>0.05). In the observation group, the mean PTA decreased from (35.29±7.25) dB HL preoperatively to (19.06±4.96) dB HL at 18 months postoperatively, and the mean air-bone gaps (ABG) decreased from (16.72± 4.95) dB HL preoperatively to (7.66±3.37) dB HL at 18 months postoperatively. In the control group, the mean PTA decreased from (33.23±5.71) dB HL preoperatively to (17.76±2.55) dB HL at 18 months postoperatively, and the mean ABG from (15.36±4.73) dB HL preoperatively to (7.45±2.67) dB HL at 18 months postoperatively. There was no significant difference in the decreasing degree of mean PTA and ABG between two groups (P>0.05). The operation time of the observation group was significantly shorter than that of the control group [(27.72±3.03) vs. (31.71±3.95) min]. The VAS score of postoperative ear fullness in the observation group was significantly lower than that of the control group (P<0.01). Conclusion: Endoscopic inlay butterfly cartilage myringoplasty and underlay tragus perichondrium myringoplasty both have good clinical effect on moderate tympanic membrane perforation with high success rate and less complications, however, the former takes less time and leads to less postoperative fullness.
