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Timpanoplastia tipo I endoscópica en niños y adultos serie de casos y comparación con la técnica bajo microscopio

Authors: Ramirez Osorio, Julian Alejandro; Rivas, Jose Antonio; Forero, Victor; Navarro, Adriana;

Timpanoplastia tipo I endoscópica en niños y adultos serie de casos y comparación con la técnica bajo microscopio

Abstract

La Timpanoplastia continúa siendo un procedimiento muy frecuente en la práctica otológica. A pesar de su alta frecuencia sigue presentando una tasa de fallas al rededor de 15%, morbilidad y costos médicos altos, que obligan a explorar otras alternativas. Métodos. Estudio de cohorte prospectivo de Timpanoplastia I o Miringoplastia (MP) endoscópica en niños y adultos, comparado con un grupo de MP con microscopio, realizando análisis de variables demográficas, audiológicas y resultado anatómico postoperatorio. Resultados Durante el período Julio 2013-Julio 2015 se analizaron 228 procedimientos de MP, de ellos 78.5% endoscópicos y 21.4% con microscopio. La distribución por edades fue 41.9% niños y 58.1% adultos. Se trató toda clase de perforaciones timpánicas en ambos grupos. Se encontraron más casos de audición normal pre operatoria en niños y mayor proporción de casos con hipoacusias severas en adultos. El promedio de tonos puros (PTA) preoperatorio en niños fue de 25.8 dB-HL y 36.1 dB-HL en adultos, con PTA posoperatorio de 16.7 dB-HL y 27.5 dB-HL respectivamente. El PTA preoperatorio fue similar en los grupos de microscopio y endoscopio (31dB), siendo levemente menor el PTA posoperatorio con microscopio (23dB vs 19.1 p= ) El cierre brecha aéreo-ósea fue de 10.3 dB en la muestra. El promedio de duración de la cirugía fue de 52 minutos con endoscopio y 75 con microscopio (p=). La falla de la Timpanoplastia o re perforación apareció en 19/179 y 2/49. (p=?) Conclusiones. La MP endoscópica es una técnica que muestra similares resultados a los descritos con microscopio, con igual éxito de integración del injerto, resultados audiológicos y con un significativo menor tiempo quirúrgico.

Summary. Tympanoplasty remains a very common procedure in otologic practice. Despite its high frequency still has a failure rate of around 15%, morbidity and medical costs, which force to explore other alternatives. Methods. Prospective cohort study of tympanoplasty I or Myringoplasty (MP) endoscopy in children and adults, compared with a group of MP microscope, performing analysis of demographic variables, postoperative audiological and anatomical results. Results During the period July 2013-July 2015 MP 228 procedures, of which 78.5% and 21.4% endoscopic microscopically analyzed. The age distribution was 41.9% boys and 58.1% adults. all kinds of tympanic perforations in both treated groups. more cases of preoperative normal hearing children and a higher proportion of cases with severe hearing loss in adults were found. The pure tone average (PTA) preoperative children was 25.8 dB and 36.1 dB-HL-HL in adults with postoperative PTA 16.7 dB and 27.5 dB-HL-HL respectively. The preoperative PTA was similar in the microscope and endoscope (31dB), with slightly lower postoperative PTA microscope (23dB vs 19.1 p =) Closing air-bone gap was 10.3 dB in the sample. The average operating time was 52 minutes and 75 endoscope microscope (p =). The failure of tympanoplasty or re drilling appeared in 19/179 and 2/49. (P =) Conclusions. MP endoscopy is a technique that shows similar results to those described under the microscope, with equal success of graft integration, audiological results and a significant minor surgical time.

Country
Colombia
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Keywords

perforacion timpanica, TIMPANOPLASTIA, Ear drum perforation, Endoscopy, Timpanoplastia, Endoscopic ear surgery, Cirugia endoscopica de oido, MICROSCOPIA MEDICA, Otitis media crònica, ULTRASONOGRAFIA ENDOSCOPICA, Tympanoplasty, Endoscopia, Cronic media otitis, Miringoplastia

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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