[Clinical effect and influencing factors of endoscopic type I tympanoplasty]

Abstract

A retrospective analysis was conducted on the clinical data of 103 patients who underwent type Ⅰ tympanoplasty under endoscopy at the Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital between January 2020 and February 2023. Among them, 36 were males and 67 were females, with a median age M [(Q₁, Q₃)] of 49 (35, 59) years. After a three-month follow-up, the tympanic membrane healing rate was 92.2% (95/103). Multivariate logistic regression model analysis showed that the absence of preoperative hypertension (OR=1.48, 95%CI: 1.13-1.75), a preoperative sound compliance value>0.2 (OR=1.77, 95%CI: 1.28-3.92), a preoperative wet ear condition (OR=2.27, 95%CI: 1.02-5.06), and the use of perichondrium for repair during surgery (OR=1.42, 95%CI: 1.27-3.52) were influencing factors of hearing improvement. Notably, patients with wet ears exhibited higher improvement in air-bone gap at low frequencies (250, 500, and 1 000 Hz) compared to those with dry ears (all P<0.05). These findings suggest that type Ⅰ tympanoplasty under endoscopy achieves favorable clinical outcomes. Preoperative blood pressure control, and the intraoperative use of perichondrium grafts can effectively enhance post-operative hearing improvement.