Transkanal timpanoplastide mikroskopik ve endoskopik yaklaşımlarının karşılaştırılması
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Tarih
2023
Yazarlar
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Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada timpanik membran perforasyonu olan hastaların cerrahi tedavisinde mikroskopik ve endoskopik yöntemlerinin postoperatif objektif ve subjektif parametreleriyle birbirine olan üstünlüklerini karşılaştırmayı amaçladık.
Materyal ve Method: Aralık 2022 ile Haziran 2023 tarihleri arasında Necmettin Erbakan Üniversitesi Kulak Burun Boğaz ve Baş Boyun Cerrahisi Anabilim Dalı'nda 18-65 yaşları arasında kronik otitis media tanısı konmuş ve timpanoplasti operasyonu önerilen 61 hastayı araştırmamıza dahil edildi. 31 hastaya mikroskopik yöntemle transkanal timpanoplasti gerçekleştirildi. 30 hastaya ise endoskopik yöntemle transkanal timpanoplasti gerçekleştirildi. Operasyon öncesi tüm hastalara saf ses odyometri ve temporal kemik BT çekildi. Postoperatif birinci günü ağrı için Görsel Analog skala (VAS) ağrı ölçeği kullanılarak kaydedildi. Postoperatif ikinci ayda ise işitme düzeyleri saf ses odyometri ile greftin tutma başarısı ise endoskopik görüntüler ile kaydedildi.
Bulglular: Çalışmamızda, her iki grupta hastaların demografik verileri eşit dağılım göstermekte olup, istatistiksel olarak anlamlı fark yoktu (p > 0,05). Mikroskopik timpanoplasti grubunda postoperatif greft başarı oranı %86,7, endoskopik timpanoplasti grubunda ise %80,6 olarak kaydedildi (p = 0,525). Preoperatif ve postoperatif dönemlerde saf ses hava-kemik aralığı mikroskopik ve endoskopik gruplarda da anlamlı bir şekilde azalmıştır (p < 0,001). İstatistiksel olarak, iki cerrahi yöntem arasındaki hava-kemik aralığındaki değişim benzer olduğu saptanmıştır (p = 0,521). Hastaların ağrı skorları (VAS) karşılaştırıldığında ise gruplar arası anlamlı farklılık yoktu (p = 0,279).
Sonuç: Bu çalışma, greft başarı oranı ve odyolojik veriler açısından her iki timpanoplasti yönteminin istatistiksel olarak benzer sonuçlar gösterdiğini ortaya koymuştur. Çalışmamızın objektif ve subjektif sonuçlarına göre, mikroskopik transkanal timpanoplasti sonuçları oldukça tatmin edicidir. Minimal invaziv cerrahi olarak kabul edilen endoskopik yöntemle elde edilen sonuçlara eşdeğer olduğu sonucuna vardık.
Objective: In this study, we aimed to compare the superiority of microscopic and endoscopic methods in the surgical treatment of patients with tympanic membrane perforation in terms of postoperative objective and subjective parameters. Materials and Methods: Between December 2022 and June 2023, 61 patients aged 18-65 diagnosed with chronic otitis media and recommended for tympanoplasty surgery were included in our study at Necmettin Erbakan University Department of Otorhinolaryngology and Head and Neck Surgery. Transcanal tympanoplasty was performed using the microscopic method on 31 patients. For the remaining 30 patients, the procedure was done using the endoscopic method. Prior to the surgery, all patients underwent pure tone audiometry and temporal bone CT scans. On the first postoperative day, pain was recorded using the Visual Analog Scale (VAS) for pain. In the second postoperative month, hearing levels were recorded with pure tone audiometry, and graft success was documented with endoscopic images. Results: In our study, the demographic data of the patients in both groups were equally distributed, with no statistically significant difference (p > 0.05). The graft success rate in the microscopic tympanoplasty group was recorded as 86.7%, and 80.6% in the endoscopic tympanoplasty group (p = 0.525). The air-bone gap in pure tone audiometry decreased significantly in both the preoperative and postoperative periods for both groups (p < 0.001). Statistically, the change in the air-bone gap between the two surgical methods was found to be similar (p = 0.521). When comparing the pain scores (VAS) of the patients, there was no significant difference between the groups (p = 0.279). Conclusion: This study revealed that both tympanoplasty methods showed statistically similar results in terms of graft success rate and audiological data. Based on the objective and subjective outcomes of our study, the results of microscopic transcanal tympanoplasty are quite satisfactory. We concluded that it is equivalent to the results obtained with the endoscopic method, which is considered minimally invasive surgery.
Objective: In this study, we aimed to compare the superiority of microscopic and endoscopic methods in the surgical treatment of patients with tympanic membrane perforation in terms of postoperative objective and subjective parameters. Materials and Methods: Between December 2022 and June 2023, 61 patients aged 18-65 diagnosed with chronic otitis media and recommended for tympanoplasty surgery were included in our study at Necmettin Erbakan University Department of Otorhinolaryngology and Head and Neck Surgery. Transcanal tympanoplasty was performed using the microscopic method on 31 patients. For the remaining 30 patients, the procedure was done using the endoscopic method. Prior to the surgery, all patients underwent pure tone audiometry and temporal bone CT scans. On the first postoperative day, pain was recorded using the Visual Analog Scale (VAS) for pain. In the second postoperative month, hearing levels were recorded with pure tone audiometry, and graft success was documented with endoscopic images. Results: In our study, the demographic data of the patients in both groups were equally distributed, with no statistically significant difference (p > 0.05). The graft success rate in the microscopic tympanoplasty group was recorded as 86.7%, and 80.6% in the endoscopic tympanoplasty group (p = 0.525). The air-bone gap in pure tone audiometry decreased significantly in both the preoperative and postoperative periods for both groups (p < 0.001). Statistically, the change in the air-bone gap between the two surgical methods was found to be similar (p = 0.521). When comparing the pain scores (VAS) of the patients, there was no significant difference between the groups (p = 0.279). Conclusion: This study revealed that both tympanoplasty methods showed statistically similar results in terms of graft success rate and audiological data. Based on the objective and subjective outcomes of our study, the results of microscopic transcanal tympanoplasty are quite satisfactory. We concluded that it is equivalent to the results obtained with the endoscopic method, which is considered minimally invasive surgery.
Açıklama
Anahtar Kelimeler
Timpanoplasti, Transkanal, Endoskop, Mikroskop, Tympanoplasty, Transcanal, Endoscope, Microscope
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Abakır, N. (2023). Transkanal timpanoplastide mikroskopik ve endoskopik yaklaşımlarının karşılaştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Kulak Burun Boğaz Anabilim Dalı, Konya.
