Vincent Robert, Oates John, Sperling Neil M
Jean Causse Ear Clinic, Traverse de Béziers, Clombiers, France.
Otol Neurotol. 2002 Nov;23(6):866-72. doi: 10.1097/00129492-200211000-00010.
Performing stapedotomy in cases of tympanosclerotic stapes fixation is controversial. The procedure is traditionally considered to carry a high risk of postoperative sensorineural hearing loss. The aim of this study was to report the hearing results in surgically treated cases of stapes fixation.
A retrospective review of tympanosclerosis of the oval window with stapes fixation.
The study was performed at the Jean Causse Ear Clinic in Clombiers, France.
Sixty-five patients who underwent surgery for tympanosclerotic stapes fixation between January 1992 and October 1999.
Stapedotomy with vein graft interposition and reconstruction with a Teflon piston, or a total prosthesis in cases of incudal erosion.
Preoperative and postoperative audiometric evaluation using conventional audiometry. Air-bone gap, bone conduction threshold, air conduction threshold, and Glasgow Benefit Plot were measured.
Postoperative air-bone gap closure to within 10 dB was achieved in 39% of cases. An air-bone gap less than 20 dB was obtained in 70% of cases. Significant postoperative improvement of air conduction thresholds, more than 20 dB, was found in 46% of cases. The postoperative bone conduction thresholds were unchanged in 92% of cases. No significant sensorineural hearing loss was seen in this series.
This series demonstrates that safe and successful stapedotomy is possible if certain rules are respected.
在鼓室硬化症导致的镫骨固定病例中进行镫骨切除术存在争议。传统上认为该手术术后感音神经性听力损失风险较高。本研究的目的是报告接受手术治疗的镫骨固定病例的听力结果。
对伴有镫骨固定的椭圆窗鼓室硬化症进行回顾性研究。
该研究在法国克洛姆比耶的让·考斯耳科诊所进行。
1992年1月至1999年10月间接受鼓室硬化症镫骨固定手术的65例患者。
采用静脉移植介入的镫骨切除术，并用聚四氟乙烯活塞进行重建，对于砧骨侵蚀的病例则使用全人工听骨。
使用传统听力测定法进行术前和术后听力评估。测量气骨导差、骨导阈值、气导阈值和格拉斯哥听力受益图。
39%的病例术后气骨导差缩小至10 dB以内。70%的病例气骨导差小于20 dB。46%的病例术后气导阈值有显著改善，提高超过20 dB。92%的病例术后骨导阈值未变。本系列中未观察到明显的感音神经性听力损失。
本系列研究表明，如果遵循某些规则，镫骨切除术可以安全成功地进行。
