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目的探讨带蒂颞肌筋膜隧道皮瓣作为修补及支撑组织应用于鼓室成形术中的临床功效。方法选择病变较轻的中耳炎96耳,其中46耳以带蒂颞肌筋膜隧道膜瓣为修补材料行鼓室成形术I型,另外50耳以游离颞肌筋膜修补鼓膜,作出对比;选择病变较重的中耳炎73耳,其中23耳去除外耳道后壁再以带蒂颞肌筋膜隧道膜瓣作为外耳道后壁软支架,另外50耳行乳突根治术,作出对比。结果经过半年随访,转蒂移植的颞肌筋膜隧道皮瓣愈合良好,该组成活率为97.8%,游离颞肌筋膜组为88.0%,术后听力提高相仿。以带蒂颞肌筋膜瓣作为外耳道后壁软支架的病例组术后半年干耳率91.3%,乳突根治术半年干耳率92.0%,术后半年听力提高前者大于后者,行t检验提示有差别。结论带蒂颞肌筋膜隧道膜瓣可作为良好的修补及支撑组织应用于慢性化脓性中耳炎的手术中。
Objective To investigate the clinical efficacy of pedicled temporal fascia tunnel flap as a repair and supportive tissue for tympanoplasty. Methods 96 ears with mild otitis media were selected. Forty-six ears were treated by Tympanic myofascial tunnel membrane flap as tympanoplasty type I, while the other 50 ears were treated with free temporal fascia to repair tympanic membrane. Severe otitis media 73 ears, of which 23 ears to remove the posterior wall of the external auditory meatus pedunculated posterior temporal muscle fascia tunnel flap as the soft tissue of the posterior wall of the ear canal, the other 50 lines mastoid radical surgery to make a comparison. Results After six months of follow-up, the flap of the temporal fascia tunnel turned well after the transplantation. The survival rate was 97.8% in this group and 88.0% in the free temporal fascia group. The cases with pedunculated temporalis myofascial flap as the soft-shelves of posterior wall of external auditory meatus were 91.3% in half a year and 92.0% in half a year after radical mastoidectomy. Tips are different. Conclusion The pedunculated temporalis fascia tunnel flap can be used as a good repair and supporting tissue for the treatment of chronic suppurative otitis media.