70歲以上患者接受內嵌式軟骨鼓室成形術後之聽力分析

Hearing Results of Inlay Cartilage Tympanoplasty in Patients Older Than 70 Years

羅仁成(Ren-Cheng Luo) ； 張卉芝(Catherine Chang) ； 王文弘(Wen-Hung Wang) ； 黃建嘉(Chi-Che Huang)

《台灣耳鼻喉頭頸外科雜誌》 50卷3期 (2015/09) Pp. 153-158

https://doi.org/10.6286/2015.50.3.153

摘要

背景：有些高齡的中耳炎病患因為醫療合併症或不適合接受全身麻醉手術，Eavey在1998年提出可在局部麻醉下進行的內嵌式軟骨鼓室成形術，提供了更加便捷和安全的方法以達成耳膜修補。目前少有文獻報告，老年人在接受內嵌式軟骨鼓室成形術後的聽力結果。方法：以回溯性分析，收集長庚紀念醫院於2006年3月至2008年3月間接受內嵌式軟骨鼓室成形術的所有病患。其中有8名年紀大於70歲，故納入本研究中。我們回顧收集這8名患者的臨床資料，分析患者術前、短期術後和長期術後之聽力結果。結果：共計8名（男性4名，女性4名）70歲以上患者接受局部麻醉下內嵌式軟骨鼓室成形手術，平均年齡73.63歲（70-76歲）。這8名患者術後追踨耳膜皆成功修復，在氣導聽力方面，術前平均聽力閾值為65.5 ± 15.4 dB HL，短期術後聽力為61.4 ± 14.8 dB HL、長期術後聽力為62.3 ± 15.3 dB HL；氣骨導差改善方面，短期術後改善了5.5 ± 9.9 dB、長期術後改善了8 ± 10.2 dB。結論：內嵌式軟骨鼓室成形術成功率和術後聽力結果與下墊式鼓室成形術相似，因此對於大於70歲以上高齡慢性中耳炎患者無法接受全身麻醉下的鼓室成形手術時，可考慮局部麻醉下內嵌式軟骨鼓室成形術。

關鍵字

內嵌式軟骨鼓室成形術 ； 年老 ； 慢性中耳炎

並列摘要

BACKGROUND: Some elderly patients with chronic otitis media are unable to undertake surgery under general anesthesia due to underlying diseases. Inlay cartilage tympanoplasty under local anesthesia provides more convenient and safe way to achieve eardrum repair. There have been few studies of the long-term hearing results of inlay tympanoplasty on elderly patients. METHODS: We conducted a retrospective review of all patients undertaken inlay cartilage tympanoplasty at Chang Gung Memorial Hospital between March 2006 and March 2008. Eight patients older than 70 years were enrolled in this study. Clinical data, preoperative, short- and long-term postoperative hearing results were analyzed. RESULTS: There were 8 patients (4 males and 4 females) with average age 73.63 (70-76 years) undertaken inlay tympanoplasty under local anesthesia. Graft take rate was 100%. The mean pre- and post-operative short- and long-term hearing thresholds were 65.5 ± 15.4, 61.4 ± 14.8 and 62.3 ± 15.3 dB HL, respectively. The average air-bone gap closure was 5.5 ± 9.9 dB in the short-term and 8 ± 10.2 dB in the long-term hearing examinations. CONCLUSIONS: Inlay cartilage tympanoplasty has similar prognosis and hearing results compared with traditional tympanoplasty. For patients with chronic otitis media older than 70 years, who were unable to undertake tympanoplasty under general anesthesia, inlay cartilage tympanoplasty under local anesthesia should be considered.

並列關鍵字

inlay cartilage tympanoplasty ； elderly ； chronic otitis media