| Objective:By discussing the clinical efficacy of type Ⅰ tympanoplasty under microscope and otoscope,and evaluating the advantages and disadvantages of the two methods,it can help clinicians choose surgical methods and provide suggestions.Methods:A retrospective analysis of 183 patients with tympanic perforion(tympanicperforion)who were admitted to the Department of Otorhinolaryngology,First Affliated Hospital of Dali University from September 2017 to 2020.9.Among them,there were 89 patients with tympanic membrane perforation in the microscope group.In the microscope group,they were divided into 3 groups according to the size of the tympanic membrane perforation.The small perforation was group a,the medium perforation was group b,and the large perforation was group c.There are 94 patients with tympanic membrane perforation in the otoscope group.In the otoscope group,they are also divided into 3 groups according to the size of the tympanic membrane perforation.Small perforations are group A,medium perforation group B,and large perforation group C.The operation time,24 hours postoperative pain degree,hospitalization days,as well as the healing of the tympanic membrane and the hearing comparison(pre-operation)after 6 months of follow-up were counted in each group,and SPSS 25.0 was used for statistical analysis.Results:There were a total of 183 patients with tympanic membrane perforation in this study.There were 94 patients who underwent type Ⅰ tympanoplasty under otoscope,including 22 patients with small perforation,40 patients with medium perforation,and 32 patients with large perforation.There were 89 patients undergoing type Ⅰ tympanoplasty under a microscope,including 19 patients with small perforation,34 patients with medium perforation,and 36 patients with large perforation.In terms of gender and age,the results of each group of patients were not significantly different(P>0.05).1.According to various evaluation indicators,there are statistically significant differences in operation time,postoperative pain and hospitalization days between the otoscope group and the microscope group(P<0.05).The average hearing improvement of patients in otoscope group B and C were 11.90±1.58 dB and 11.25±1.31 dB,respectively;the average hearing improvement of patients in group B and group c was 11.91 ± 1.63 dB and 11.30±1.47 dB,respectively.Under large and medium perforations,there was no statistically significant difference in hearing improvement between the two groups of otoscope and microscope(P>0.05).The healing rates of the tympanic membranes in the otoscope group B and C were 95.0%and 87.5%,respectively;the healing rates of the patients in the microscopic group B and C were 94.0%and 88.8%,respectively.Under large and medium perforations,the healing rate of the tympanic membrane in the otoscope group and the microscope group was not statistically significant(P>0.05).(Note:Since the area of the small perforation is less than 25%,most of the hearing level before the operation is within the normal range,and the hearing improvement is not significantly improved.Therefore,the hearing improvement of the ear endoscopy group and the microscope group in the small perforation is no longer compared;In the perforation group,there are 0 people who have not healed in the ear endoscopy group and the microscope group,and the chi-square test is relatively meaningless,so the chi-square test in the ear endoscopy group and the microscope group in the small perforation is no longer performed)2.In the otoscope group,there was no statistically significant difference in the operation time,24 hours of postoperative pain,hospitalization days,and hearing improvement in groups A,B and C(P>0.05).The healing rate of the tympanic membrane in the otoscope group A was 100%,the healing rate of the tympanic membrane in the otoscope group B was 95.0%,and the healing rate of the otoscope C group was 87.5%.The healing rate of the three groups A,B and C is different,with statistical significance(P<0.05).3.In the microscope group,there was no statistically significant difference in the operation time,24 hours of postoperative pain,hospitalization days,and hearing improvement in the three groups a,b,and c(P>0.05).The healing rate of the tympanic membrane of the patients in the microscope group a was 100%,the healing rate of the tympanic membrane of the patients in the microscope group b was 94.0%,and the healing rate of the tympanic membrane in the microscope group c was 88.8%.There were differences in the healing rate of the three groups a,b and c,which was statistically significant(P<0.05).Conclusion:1.The tympanic membrane healing rate and hearing improvement after type Ⅰ tympanoplasty in the otoscope group were comparable to those in the microscope group.2.Compared with type Ⅰ tympanoplasty under otoscope and type Ⅰ tympanoplasty under microscope,the advantage of tympanoplasty under otoscope are short time-consuming,light postoperative pain,and short hospital stay.3.Whether it is under the otoscope or under the microscope,different sizes of tympanic membrane perforations have different healing rates after I tympanoplasty.The larger the perforation area,the lower the healing rate;the smaller the perforation area,the higher the healing rate. |
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