胶原生物膜在耳内镜下中耳胆脂瘤乳突根治术中的应用效果分析

摘要 目的：探讨胶原生物膜在耳内镜下乳突根治术中的应用效果。方法：选取徐州医科大学附属医院2021年4月至2022年 2月收治的51例中耳胆脂瘤患者进行回顾性分析，其中研究组27例患者予以胶原生物膜修复皮肤缺损，对照组予以颞肌筋膜修复术腔皮肤缺损，观察两组患者术后临床症状，手术时长，术腔完全上皮化时间、干耳时间及术前术后听力改变。结果：研究组术后患者因外耳道进水，存在感染及肉芽生长者1例，予以清理后未再次生长；对照组术后发生1例外耳道口狭窄的情况，予以橡胶扩张管进行扩张并后并定期清理术腔肉芽、脱落痂皮，患者外耳道恢复良好。两组术前耳闷、耳痛、耳鸣及术后耳痛VAS评分无明显差异（P>0.05）；研究组术后耳闷及耳鸣VAS评分较对照组降低（P<0.05）。研究组平均手术时长、术后术腔完全上皮化时间及平均干耳时间短于对照组（P<0.05）。两组术前术后气骨导差（ABG）、平均气导听阈（AC）比较差异均无统计学意义（P＞0.05）。结论：作为术区移植物，胶原生物膜应用于耳内镜下中耳胆脂瘤乳突根治术可加快创面术腔的修复，减少局部创伤与操作步骤，改善临床症状，缩短手术时间、术后术腔完全上皮化时间及获得干耳时间，可作为临床上有效的修复材料。

Analysis of the Application Effect of Collagen Biofilm in Endoscopic Radical Mastoidectomy for Middle Ear Cholesteatoma

ABSTRACT Objective: To investigate the effect of collagen biofilm in endoscopic radical mastoidectomy for middle ear cholesteatoma. Methods: A total of 51 patients with middle ear cholesteatoma admitted to the Affiliated Hospital of Xuzhou Medical University from April 2021 to February 2022 were retrospectively analyzed. Among them, 27 patients in the study group were treated with collagen biofilm to repair skin defects, while 24 patients in the control group was treated with temporalis fascia to repair skin defects in the operative cavity. The postoperative clinical symptoms, surgical duration, complete epithelialization time of the operative cavity, dry ear time and hearing changes before and after operation were observed in the two groups. Results: In the study group, 1 patient had infection and granulation growth due to external auditory canal water intake, and did not grow again after cleaning.In the control group, 1 case of external auditory canal stenosis occurred after operation, and the rubber expansion tube was used for expansion and then the granulation of the surgical cavity and the shedding of the scab were regularly cleaned, the patient ''s external auditory canal recovered well. There was no significant difference in the VAS scores of preoperative aural stuffiness, earache, tinnitus and postoperative earache between the two groups(P>0.05). The VAS scores of aural stuffiness and tinnitus in the study group were lower than those in the control group (P<0.05). The average surgical duration, postoperative complete epithelialization time of the operative cavity and average dry ear time in the study group were shorter than those in the control group(P<0.05). There was no significant difference in preoperative and postoperative air-bone gap (ABG) and average air conduction (AC) between the two groups (P>0.05). Conclusion: As a graft in the operation area, the application of collagen biofilm in endoscopic radical mastoidectomy for middle ear cholesteatoma can accelerate the repair of the wound cavity, reduce local trauma and operation steps, improve clinical symptoms, shorten the surgical duration, complete epithelialization time of the operation cavity and time of obtaining dry ear, which can be used as an effective repair material in clinic.