Objective

This study compared the long-term graft success rates and hearing outcomes of overlay-underlay and underly cartilage myringoplasty for repairing large perforations in Teenagers.

Study design: prospective, randomized study.

Setting

Tertiary referral center.

Methods

Pediatric patients older than 12 years with chronic perforations were randomly divided into two groups:intervention group (n = 39) and control group (n = 41). The graft success rate, hearing improvement, and complications were compared between the two groups.

Results

A total of 80 patients were included in this study. The graft success rate was 100% in the intervention group and 95.1% in the control group at postoperative 3 months, the difference wasn't significant (P = 0.496). Also, the graft success rate was not significantly different between the two groups at 12 months postoperatively (100.0% vs 87.8%, p = 0.073). However, the difference of graft success rate was significant between the two groups at 24 months postoperatively (97.4% vs 75.6%, p = 0.012). CT examination revealed well-pneumatized middle ears 24 months after surgery in both group. However, epithelial pearls near the umbo were seen at 31 months postoperatively in one patient in the observation group.

Conclusions

Compared to the endoscopic cartilage with perichondrium composite graft underlay technique, endoscopic perichondrial graft overlay and cartilage underlay had a better long-term graft success rate and lower rate of long-term re-perforation in teenagers. However, the graft technique had no effect on hearing outcome.

中文翻译：

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内窥镜镶嵌软骨和软骨膜鼓膜成形术修复青少年大穿孔

客观的

本研究比较了覆盖垫层和下层软骨鼓膜成形术修复青少年大穿孔的长期移植成功率和听力结果。

研究设计：前瞻性、随机研究。

环境

三级转诊中心。

方法

12岁以上慢性穿孔患儿随机分为两组：干预组（n  =39）和对照组（n  =41）。比较两组移植成功率、听力改善情况及并发症情况。

结果

本研究共纳入 80 名患者。术后3个月，干预组移植成功率为100%，对照组移植成功率为95.1%，差异不显着（P=0.496）。此外，两组在术后 12 个月的移植成功率没有显着差异（100.0% 对 87.8%，p = 0.073）。然而，两组在术后 24 个月的移植成功率差异显着（97.4% vs 75.6%，p = 0.012）。CT检查显示两组术后24个月的中耳通气良好。然而，观察组中的一名患者在术后 31 个月时在 umbo 附近看到了上皮珍珠。

结论

与内窥镜软骨膜复合移植垫技术相比，内窥镜软骨膜移植垫和软骨垫在青少年中具有更好的长期移植成功率和较低的长期再穿孔率。然而，移植技术对听力结果没有影响。