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目的:探讨鼓室成形术后新鼓膜在不同阶段的形态变化,以及影响其变化的相关因素与对策。方法:对120耳鼓室成形术病例,分别观察术后1～3个月、4～6个月、6～24个月及2年以上的新鼓膜变化情况,分析影响其变化的相关因素,并进行相关处理。结果:术后2周抽出外耳道纱条后见新鼓膜前下边缘出现裂隙4耳;1～3个月再感染穿孔2耳;4～6个月可疑咽鼓管功能不良24耳,功能未恢复4耳;6个月～2年鼓膜萎缩13耳。术后总继发穿孔10耳(8.33％)。结论:新鼓膜前下边缘裂隙是早期鼓膜穿孔的主要表现;鼓室及咽鼓管鼓口粘膜病变严重是新鼓膜穿孔和影响移植物成活的主要原因。咽鼓管导管吹张是改善鼓室通气、提高听力的方法之一。新鼓膜功能及形态多在3个月后趋于稳定。
Objective: To investigate the morphological changes of the new tympanic membrane after tympanoplasty at different stages, as well as the related factors that affect its changes and countermeasures. Methods: The 120 cases of tympanoplasty cases were observed after 1 to 3 months, 4 to 6 months, 6 to 24 months and more than 2 years of new tympanic membrane changes, analyze the impact of changes related factors, and Related processing. Results: 4 weeks after removal of the external auditory canal sliver after 2 weeks of surgery, 4 ears were found at the anterior and posterior margin of the new tympanic membrane, 2 ears were perforation in 1 ~ 3 months, 24 ears were suspicious of eustachian tube dysfunction in 4 ~ 6 months, and the function was not restored 4 ears; 6 months to 2 years eardrum 13 ears. Postoperative total secondary perforation 10 ears (8.33%). Conclusion: The fissure of the anterior margin of the new tympanic membrane is the main manifestation of the early perforation of the tympanic membrane. The severe tympanic and eustachian tube kyphosis is the main cause of the perforation of the new tympanic membrane and the survival of the graft. Eustachian tube catheter blowing is to improve tympanic ventilation, improve hearing one way. New tympanic membrane function and morphology in 3 months after more stable.