Objective:Various materials have been used for tympanic membrane reconstruction in middle ear surgery.This study aimed to evaluate the difference between the tragal perichondrium and COOK arti-ficial material in patie...Objective:Various materials have been used for tympanic membrane reconstruction in middle ear surgery.This study aimed to evaluate the difference between the tragal perichondrium and COOK arti-ficial material in patients who underwent endoscopic type 1 tympanoplasty.Method:This retrospective study included patients who underwent endoscopic type 1 tympanoplasty from June 2021 to June 2022 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Patients were divided into group A(tragal perichondrium)and group B(COOK artificial material)ac-cording to the material used in the operation.All patients were followed up for 6 months.The differences in age,gender,operation site,disease course,preoperative air-bone gap(ABG),operation time,blood loss,hearing gain,and wound healing rate were compared between the two groups.Results:This study enrolled 197 patients,with 120 patients in group A and 77 patients in group B.There were no significant differences in age,gender,operation site,disease course,or preoperative ABG be-tween groups A and B(p>0.05).Both groups had significant postoperative improvement in hearing(group A:30.98±9.58 dB vs.17.07±9.92 dB,p<0.001;group B:29.75±7.52 dB vs.14.25±9.07 dB,p<0.001).The mean hearing gain in group A and group B was comparable(14.02±11.91 dB vs.15.50±7.05 dB,p=0.609).The wound healing rates of groups A and B were no differences(93.33%vs.87.01%,p=0.133).The patients in group B had a shorter operation duration(72.57±11.32 min vs.61.86±9.27 min,p=0.045)and less blood loss(12.38±3.7 mL vs.8.10±2.43 mL,p=0.004).Conclusions:Tragal perichondrium and COOK artificial material are reliable for functional and anatomical outcomes in endoscopic type 1 tympanoplasty,and COOK artificial material can save operation time and blood loss in surgery compared to the tragal perichondrium.展开更多
BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an id...BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.展开更多
Objective To investigate anterior tragal perforating aftery( ATPA) and provide anatomic basis for flap derived from preauricular area. Methods Twenty ( 40 sides) cadaver heads fixed in 10% formalin solution and perfus...Objective To investigate anterior tragal perforating aftery( ATPA) and provide anatomic basis for flap derived from preauricular area. Methods Twenty ( 40 sides) cadaver heads fixed in 10% formalin solution and perfused with red - colored latex were used to perform gross anatomy study. Two heads of fresh cadaver展开更多
目的探讨耳内镜下耳屏软骨-软骨膜重建外耳道后壁或上鼓室外侧壁的临床应用及术后效果。方法回顾性分析2015年8月~2019年8月期间住院手术的52例(52耳)外耳道及中耳胆脂瘤患者的临床资料,病变均累及上鼓室及鼓窦,其中45例为中耳胆脂瘤,7...目的探讨耳内镜下耳屏软骨-软骨膜重建外耳道后壁或上鼓室外侧壁的临床应用及术后效果。方法回顾性分析2015年8月~2019年8月期间住院手术的52例(52耳)外耳道及中耳胆脂瘤患者的临床资料,病变均累及上鼓室及鼓窦,其中45例为中耳胆脂瘤,7例为外耳道胆脂瘤,均在耳内镜下行上鼓室开放术同期行鼓室成形,术中用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,分析手术技术要点、观察术后干耳时间、鼓膜愈合、上鼓室外侧壁塌陷及听力疗效等相关情况。结果52例(52耳)术后平均随访时间26.3±7.2个月,术后平均干耳时间27.5±8.8天;鼓膜完全愈合47耳(90.4%,47/52),其中鼓膜完全愈合且形态正常41耳(78.8%,41/52),鼓膜愈合但内陷6耳(11.5%,6/52);复发5耳(9.6%,5/52),其中紧张部内陷穿孔1耳(1/52,1.9%),松弛部内陷伴穿孔4耳(4/52,7.7%);无一例面瘫和外耳道狭窄。术后12个月,0.5、1、2、4 kHz平均气导听阈(32.1±5.8 dB HL)较术前(53.2±10.4 dB HL)明显降低(P<0.001),ABG(15.6±7.6 dB)值较术前(41.5±7.4 dB)明显降低(P<0.001)。结论对于累及上鼓室的外耳道或中耳胆脂瘤,可经耳内镜行上鼓室开放术清除病变,用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,依靠软骨的支撑,可维持鼓室、鼓窦及乳突腔含气腔,减少鼓膜松弛部内陷的发生,保持上鼓室外侧壁的基本形态。展开更多
目的了解自体耳屏软骨在鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷患者鼓室成形术中的疗效。方法将自体耳屏软骨用于11例鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷的患者,修补鼓膜,其中5例单纯行鼓膜修补,6例同期行乳突改良根治,术中...目的了解自体耳屏软骨在鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷患者鼓室成形术中的疗效。方法将自体耳屏软骨用于11例鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷的患者,修补鼓膜,其中5例单纯行鼓膜修补,6例同期行乳突改良根治,术中完整保留内陷的鼓膜,将耳屏软骨置于其内侧。结果11例移植物均成活,术后语言频率气骨导间距≤10 dB 5例;气骨导间距≤20 dB 6例。语言频率气导平均提高16.5 dB;本组患者均未发现听力回降及鼓膜回缩。结论对鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷患者利用自体耳屏软骨行鼓室成形术,移植物易成活,因术中完整保留内陷鼓膜,利用耳屏软骨对鼓膜的支撑作用,手术疗效明显提高。展开更多
目的探讨耳内镜下嵌入法蝶形软骨鼓膜成形术的临床疗效。方法对32例干性鼓膜穿孔患者,行嵌入法蝶形软骨鼓膜成形术。手术均在耳内镜下一期完成。术后复查耳内镜及纯音测听,并对结果进行分析。结果术后随访6~10个月,鼓膜成形的总愈合率为...目的探讨耳内镜下嵌入法蝶形软骨鼓膜成形术的临床疗效。方法对32例干性鼓膜穿孔患者,行嵌入法蝶形软骨鼓膜成形术。手术均在耳内镜下一期完成。术后复查耳内镜及纯音测听,并对结果进行分析。结果术后随访6~10个月,鼓膜成形的总愈合率为93%(30/32),术后听力提高>15 d B。随访期间除2例慢性中耳炎再穿孔外,其余无再穿孔。结论耳内镜下嵌入法蝶形软骨鼓膜成形术,微创可行,容易被患者接受,容易在基层医院开展推广。展开更多
In 1994, the American Otological Society reported favourable experience with composite cartilage shield tympanoplasty. The tragal cartilage with a grommet inserted in it was used for tympanoplasty in our patient with ...In 1994, the American Otological Society reported favourable experience with composite cartilage shield tympanoplasty. The tragal cartilage with a grommet inserted in it was used for tympanoplasty in our patient with unilateral CSOM, supposedly because of severe chronic eustachian tube dysfunction. The marriage of cartilage tympanoplasty with grommet insertion was aimed to add the advantages and abolish the disadvantages of both the procedures. In 1990 Lary Hall first introduced the “long term ventilation of the middle ear” with a T-tube placed in the tragal cartilage perichondrium composite island graft. T-tube insertion in the cartilage has been described. But insertion of the Indian Sheperds grommet (ventilation tube) in the cartilage graft as described in this case and its technique are possibly the first of its kinds in literature. The report is aimed to ignite innovation of newer and better techniques of cartilage tympanoplasty.展开更多
BACKGROUND The auricle,or auricula,defines the visible boundaries of the external ear and is essential in forensic investigations,including facial reconstruction and human remains identification.Beyond its forensic si...BACKGROUND The auricle,or auricula,defines the visible boundaries of the external ear and is essential in forensic investigations,including facial reconstruction and human remains identification.Beyond its forensic significance,auricular morphology attracts interest from various fields,such as medicine and industry.The size of the ears is culturally associated with health and longevity,while surgical techniques for ear reconstruction address both congenital and aesthetic concerns.AIM To determine whether known correlations with various measurements and observations regarding sex and age could also be established through computed tomography(CT).METHODS Computed tomography scans of the head from 342 females and 329 males aged 18 to 97 years(mean=60±19 years)were included in this study.Different auricular lengths,widths and perimeters were measured for both sides.Additionally,the preauricular area was assessed using three-dimensional volume rendering tech-nique images.RESULTS The measured auricular dimensions in centimeters are presented as mean values(right/left)for males(length 16.91±0.51/6.93±0.52;length 22.83±0.35/2.84±0.34;width 13.94±0.32/4.01±0.36;width 23.51±0.34/3.46±0.31;perimeter 17.66±1.25/17.71±1.28)and females(length 16.44±0.5/6.48±0.51;length 22.7±0.32/2.71±0.33;width 13.6±0.32/3.68±0.31;width 23.3±0.3/3.26±0.27;perimeter 16.36±1.2/16.46±1.2).A positive correlation with age was shown in all measurements,with the highest value for perimeter in both,males(r-value:right/left:0.49/0.47)and females(r-value:right/left:0.53/0.53).After confounding factors were excluded,the preauricular vertical line was first seen at 45 years.The mean age for males with preauricular vertical lines was 66.65±10.92 years(95%CI:63.99-69.3),while without vertical lines,it was 44.48±16.15 years(95%CI:41.21-47.74);for females,it was 70.18±12.44 years(95%CI:68.9-71.46)with and 47.87±17.09 years(95%CI:45.96-49.78)without vertical lines.CONCLUSION In this study,we pioneered the use of CT volumetric data to examine human auricle morphology and we achieved a precise 3D(pre-)auricular assessment.Sex-specific positive correlations between ear dimensions and age,as well as the mean age for the appearance of preauricular lines,were identified,providing valuable insights into the capabilities of modern CT devices.展开更多
文摘Objective:Various materials have been used for tympanic membrane reconstruction in middle ear surgery.This study aimed to evaluate the difference between the tragal perichondrium and COOK arti-ficial material in patients who underwent endoscopic type 1 tympanoplasty.Method:This retrospective study included patients who underwent endoscopic type 1 tympanoplasty from June 2021 to June 2022 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Patients were divided into group A(tragal perichondrium)and group B(COOK artificial material)ac-cording to the material used in the operation.All patients were followed up for 6 months.The differences in age,gender,operation site,disease course,preoperative air-bone gap(ABG),operation time,blood loss,hearing gain,and wound healing rate were compared between the two groups.Results:This study enrolled 197 patients,with 120 patients in group A and 77 patients in group B.There were no significant differences in age,gender,operation site,disease course,or preoperative ABG be-tween groups A and B(p>0.05).Both groups had significant postoperative improvement in hearing(group A:30.98±9.58 dB vs.17.07±9.92 dB,p<0.001;group B:29.75±7.52 dB vs.14.25±9.07 dB,p<0.001).The mean hearing gain in group A and group B was comparable(14.02±11.91 dB vs.15.50±7.05 dB,p=0.609).The wound healing rates of groups A and B were no differences(93.33%vs.87.01%,p=0.133).The patients in group B had a shorter operation duration(72.57±11.32 min vs.61.86±9.27 min,p=0.045)and less blood loss(12.38±3.7 mL vs.8.10±2.43 mL,p=0.004).Conclusions:Tragal perichondrium and COOK artificial material are reliable for functional and anatomical outcomes in endoscopic type 1 tympanoplasty,and COOK artificial material can save operation time and blood loss in surgery compared to the tragal perichondrium.
文摘BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.
文摘Objective To investigate anterior tragal perforating aftery( ATPA) and provide anatomic basis for flap derived from preauricular area. Methods Twenty ( 40 sides) cadaver heads fixed in 10% formalin solution and perfused with red - colored latex were used to perform gross anatomy study. Two heads of fresh cadaver
文摘目的探讨耳内镜下耳屏软骨-软骨膜重建外耳道后壁或上鼓室外侧壁的临床应用及术后效果。方法回顾性分析2015年8月~2019年8月期间住院手术的52例(52耳)外耳道及中耳胆脂瘤患者的临床资料,病变均累及上鼓室及鼓窦,其中45例为中耳胆脂瘤,7例为外耳道胆脂瘤,均在耳内镜下行上鼓室开放术同期行鼓室成形,术中用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,分析手术技术要点、观察术后干耳时间、鼓膜愈合、上鼓室外侧壁塌陷及听力疗效等相关情况。结果52例(52耳)术后平均随访时间26.3±7.2个月,术后平均干耳时间27.5±8.8天;鼓膜完全愈合47耳(90.4%,47/52),其中鼓膜完全愈合且形态正常41耳(78.8%,41/52),鼓膜愈合但内陷6耳(11.5%,6/52);复发5耳(9.6%,5/52),其中紧张部内陷穿孔1耳(1/52,1.9%),松弛部内陷伴穿孔4耳(4/52,7.7%);无一例面瘫和外耳道狭窄。术后12个月,0.5、1、2、4 kHz平均气导听阈(32.1±5.8 dB HL)较术前(53.2±10.4 dB HL)明显降低(P<0.001),ABG(15.6±7.6 dB)值较术前(41.5±7.4 dB)明显降低(P<0.001)。结论对于累及上鼓室的外耳道或中耳胆脂瘤,可经耳内镜行上鼓室开放术清除病变,用耳屏软骨-软骨膜重建上鼓室外侧壁或外耳道后壁,依靠软骨的支撑,可维持鼓室、鼓窦及乳突腔含气腔,减少鼓膜松弛部内陷的发生,保持上鼓室外侧壁的基本形态。
文摘目的了解自体耳屏软骨在鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷患者鼓室成形术中的疗效。方法将自体耳屏软骨用于11例鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷的患者,修补鼓膜,其中5例单纯行鼓膜修补,6例同期行乳突改良根治,术中完整保留内陷的鼓膜,将耳屏软骨置于其内侧。结果11例移植物均成活,术后语言频率气骨导间距≤10 dB 5例;气骨导间距≤20 dB 6例。语言频率气导平均提高16.5 dB;本组患者均未发现听力回降及鼓膜回缩。结论对鼓膜严重内陷回缩、或再生鼓膜严重菲薄内陷患者利用自体耳屏软骨行鼓室成形术,移植物易成活,因术中完整保留内陷鼓膜,利用耳屏软骨对鼓膜的支撑作用,手术疗效明显提高。
文摘目的探讨耳内镜下嵌入法蝶形软骨鼓膜成形术的临床疗效。方法对32例干性鼓膜穿孔患者,行嵌入法蝶形软骨鼓膜成形术。手术均在耳内镜下一期完成。术后复查耳内镜及纯音测听,并对结果进行分析。结果术后随访6~10个月,鼓膜成形的总愈合率为93%(30/32),术后听力提高>15 d B。随访期间除2例慢性中耳炎再穿孔外,其余无再穿孔。结论耳内镜下嵌入法蝶形软骨鼓膜成形术,微创可行,容易被患者接受,容易在基层医院开展推广。
文摘In 1994, the American Otological Society reported favourable experience with composite cartilage shield tympanoplasty. The tragal cartilage with a grommet inserted in it was used for tympanoplasty in our patient with unilateral CSOM, supposedly because of severe chronic eustachian tube dysfunction. The marriage of cartilage tympanoplasty with grommet insertion was aimed to add the advantages and abolish the disadvantages of both the procedures. In 1990 Lary Hall first introduced the “long term ventilation of the middle ear” with a T-tube placed in the tragal cartilage perichondrium composite island graft. T-tube insertion in the cartilage has been described. But insertion of the Indian Sheperds grommet (ventilation tube) in the cartilage graft as described in this case and its technique are possibly the first of its kinds in literature. The report is aimed to ignite innovation of newer and better techniques of cartilage tympanoplasty.
基金Supported by Schulz B received funding from Guerbet AG,No.8050.
文摘BACKGROUND The auricle,or auricula,defines the visible boundaries of the external ear and is essential in forensic investigations,including facial reconstruction and human remains identification.Beyond its forensic significance,auricular morphology attracts interest from various fields,such as medicine and industry.The size of the ears is culturally associated with health and longevity,while surgical techniques for ear reconstruction address both congenital and aesthetic concerns.AIM To determine whether known correlations with various measurements and observations regarding sex and age could also be established through computed tomography(CT).METHODS Computed tomography scans of the head from 342 females and 329 males aged 18 to 97 years(mean=60±19 years)were included in this study.Different auricular lengths,widths and perimeters were measured for both sides.Additionally,the preauricular area was assessed using three-dimensional volume rendering tech-nique images.RESULTS The measured auricular dimensions in centimeters are presented as mean values(right/left)for males(length 16.91±0.51/6.93±0.52;length 22.83±0.35/2.84±0.34;width 13.94±0.32/4.01±0.36;width 23.51±0.34/3.46±0.31;perimeter 17.66±1.25/17.71±1.28)and females(length 16.44±0.5/6.48±0.51;length 22.7±0.32/2.71±0.33;width 13.6±0.32/3.68±0.31;width 23.3±0.3/3.26±0.27;perimeter 16.36±1.2/16.46±1.2).A positive correlation with age was shown in all measurements,with the highest value for perimeter in both,males(r-value:right/left:0.49/0.47)and females(r-value:right/left:0.53/0.53).After confounding factors were excluded,the preauricular vertical line was first seen at 45 years.The mean age for males with preauricular vertical lines was 66.65±10.92 years(95%CI:63.99-69.3),while without vertical lines,it was 44.48±16.15 years(95%CI:41.21-47.74);for females,it was 70.18±12.44 years(95%CI:68.9-71.46)with and 47.87±17.09 years(95%CI:45.96-49.78)without vertical lines.CONCLUSION In this study,we pioneered the use of CT volumetric data to examine human auricle morphology and we achieved a precise 3D(pre-)auricular assessment.Sex-specific positive correlations between ear dimensions and age,as well as the mean age for the appearance of preauricular lines,were identified,providing valuable insights into the capabilities of modern CT devices.
