Kjeldsen A D, Grøntved A M
Department of Otorhinolaryngology, Odense University Hospital, Denmark.
Acta Otolaryngol Suppl. 2000;543:130-1. doi: 10.1080/000164800454198.
Patients with isolated erosion of the long incus process suffer from severe hearing loss caused by lack of continuity of the ossicular chain. This study is a retrospective evaluation of the hearing results using two different surgical procedures. Since January 1993, 12 consecutive patients with isolated erosion of the long incus process have been treated with a new surgical technique in which the ossicular chain was rebuilt with ionomeric cement. The results in hearing performance (mean pure-tone average (PTA) 0.5, 1 and 2 kHz) were evaluated pre- and post-surgery, and compared to those in a group of 20 historical controls who underwent surgery in 1991 and 1992 using incus autograft interposition. Among the 12 index patients, 7 (58%) achieved improvement in PTA of > 10 dB, in 3 there was no difference and in 2 a slight decline. Among the 20 controls, 14 (70%) achieved improvement in PTA of > 10 dB, in 4 there was a slight improvement and in 2 a decline. The difference was not statistically significant. Hearing improvement using ionomeric cement in type II tympanoplasty was satisfactory. Reconstruction of the ossicular chain with ionomeric cement is recommended, as the procedure is easy to perform, presents less risk of damage to the stapes and cochlea, requires less extensive surgery and does not exclude other surgical methods in cases of reoperation.
孤立性砧骨长突侵蚀的患者因听骨链连续性中断而患有严重听力损失。本研究是对采用两种不同手术方法的听力结果进行的回顾性评估。自1993年1月以来，连续12例孤立性砧骨长突侵蚀患者接受了一种新的手术技术治疗，即用聚羧酸锌粘固粉重建听骨链。在手术前后评估听力表现结果（平均纯音平均听阈（PTA）0.5、1和2kHz），并与1991年和1992年接受自体砧骨植入手术的20例历史对照患者的结果进行比较。在12例索引患者中，7例（58%）的PTA改善>10dB，3例无差异，2例略有下降。在20例对照患者中，14例（70%）的PTA改善>10dB，4例略有改善，2例下降。差异无统计学意义。在Ⅱ型鼓室成形术中使用聚羧酸锌粘固粉的听力改善效果令人满意。推荐用聚羧酸锌粘固粉重建听骨链，因为该手术操作简便，对镫骨和耳蜗的损伤风险较小，所需手术范围较小，并且在再次手术时不排除其他手术方法。
