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目的 :了解自体耳屏软骨 -软骨膜复合移植在鼓室成形术中的可行性和应用前景。方法 :利用自体耳屏软骨 -软骨膜复合移植修补鼓膜穿孔、上鼓室外侧壁、耳道后壁鼓室成形术 50例。结果 :50例中 47例移植物成活 ,成功率为 94% ;术后 6个月语言频率气骨导间距≤ 1 0 d BHL 2 7例 ,占 55.1 % ;气骨导间距≤ 2 0 d BHL 41例 ,占 83.7% ;气导平均提高 2 2 d BHL。术后 6个月至 4 a随访 ,未发现听力回降及鼓膜回缩。结论 :自体耳屏软骨 -软骨膜复合移植鼓室成形术后听力改善明显 ,移植易成活。移植物中软骨的弹性和硬度不影响术后听力提高 ,且对术后鼓膜有一定的支撑作用 ,因而对防止术后鼓膜回缩、听骨粘连 ,提高鼓室成形术远期效果有一定作用
Objective: To investigate the feasibility and prospect of autologous tragus cartilage-cartilage composite transplantation in tympanoplasty. Methods: Fifty cases of perforation of the tympanic membrane, tympanoplasty on the tympanic cavity and posterior wall of the tympanic membrane were repaired with autologous tragus cartilage-cartilage composite graft. Results: Of the 50 cases, 47 cases survived, with a success rate of 94%. Six months after the procedure, the frequency of air-bone conduction was less than 10 days in BHL 27 cases (55.1%); the air-bone conduction distance was less than 20 days 41 cases, accounting for 83.7%; air conduction increased by an average of 22 days BHL. After 6 months to 4 years follow-up, no hearing loss and tympanic membrane retraction were found. CONCLUSION: The auditory canal can be improved obviously after tympanoplasty with trabeculectomy combined with perichondrial membrane transplantation. The elasticity and hardness of the cartilage in the graft do not affect the postoperative hearing enhancement, and have some supportive effect on the tympanic membrane after the operation, and therefore play a role in preventing the tympanic membrane retraction, the bone adhesion and improving the long-term tympanoplasty outcome