耳内镜下鼓室成形术治疗慢性化脓性中耳炎鼓膜穿孔的疗效及 听力恢复的相关因素分析.

Objective: To investigate the efficacy of endoscopic tympanoplasty(TUO) in the treatment of tympanic membrane perforation in chronic suppurative otitis media, and analyze the relate factors affecting hearing recovery. Methods: 218 patients with chronic suppurative otitis media with tympanic membrane perforation who were treated in Handan First Hospital from March 2020 to March2022 were retrospectively analyzed. Patients were divided into group A(n=108, receiving traditional surgical treatment) and group B(n=110, receiving TUO treatment) according to the different surgical methods. The efficacy, hearing recovery and complication rate were compared between two groups. The clinical data of patients in group B were collected, and the relate factors affecting hearing recovery were analyzed by multivariate Logistic regression model. Results: The total clinical effective rate in group B was higher than that in group A(P＜0.05). The air-bone gap, bone conduction hearing threshold and air conduction hearing threshold in two groups decreased 6 months after operation, group B was lower than that of group A(P＜0.05). There was no difference in the total incidence of complications between two groups(P＞0.05). Patients were divided into good group(n=75) and poor group(n=35) according to the hearing recovery. Univariate analysis showed that, hearing recovery was related to eustachian tube, stapes, tympanic mucosa, artificial ossicular material, tensor tympani tendon and ossicular chain(P＜0.05). The results of multivariate Logistic regression model showed that: ossicular chain lesions,stapes only remaining the bottom plate, eustachian tube obstruction, bioceramic artificial ossicular materials, and no tensor tympani tendon were the independent risk factors for hearing recovery(P＜0.05). Conclusion: TUO treatment of chronic suppurative otitis media tympanic membrane perforation, which can improve the clinical treatment effect, improve hearing. Ossicular chain lesions, stapes only remaining the bottom plate, eustachian tube obstruction, bioceramic artificial ossicular materials, and no tensor tympani tendon are risk factors for hearing recovery. [ABSTRACT FROM AUTHOR]