Matković Svjetlana, Kitanoski Boris, Malicević Zivorad
Military Medical Academy, Clinic of Otorinolaryngology, Belgrade.
Vojnosanit Pregl. 2003 May-Jun;60(3):273-8. doi: 10.2298/vsp0303273m.
Otosclerosis is a progressive osteo-destructive disorder of the bony labyrinth in which the fixation of the stapes causes the hearing loss. The aim of this study was the postoperative determination of parameters of the effect of surgical intervention on hearing and the incidence of complications and, on the basis of the differences in the examined parameters of the study, the estimation of the efficacy of the two mentioned surgical techniques in the treatment of otosclerosis.
In our research 40 patients with conductive hearing loss caused by otosclerosis underwent surgery with CO2 laser. Functional results were compared postoperatively with the results of 40 patients operated by the classical technique without the use of CO2 laser. The research was accomplished as a prospective comparative study.
The air-bone interval (gap) as the difference between the rim of air and bone conductivity for separate frequencies did not significantly differ between the control and the experimental group. Both methods were effective in closing the air-bone gap with the rates of closure to within 10 dB in 82.6% and 75.3% for the laser and drill, respectively. The incidence of tinnitus was significantly lower in patients who underwent surgery with CO2 laser. The frequency of intraoperative and postoperative complications was significantly lower in the laser group. Differences were statistically significant for all parameters (p < 0.05).
On the basis of the degree of postoperative hearing improvement, tinnitus and the incidence of complications it can be concluded that the use of CO2 laser during inverse stapedoplasty represents an effective and safe method, justifying the promotion of its use in the surgical management of otosclerosis.
耳硬化症是一种累及骨迷路的进行性骨破坏疾病，镫骨固定会导致听力丧失。本研究的目的是术后确定手术干预对听力影响的参数以及并发症的发生率，并根据研究中所检测参数的差异，评估上述两种手术技术治疗耳硬化症的疗效。
在我们的研究中，40例因耳硬化症导致传导性听力损失的患者接受了二氧化碳激光手术。术后将功能结果与40例采用不使用二氧化碳激光的传统技术进行手术的患者的结果进行比较。该研究作为一项前瞻性对照研究完成。
作为不同频率下气导与骨导边缘差值的气骨间距，对照组和实验组之间无显著差异。两种方法在缩小气骨间隙方面均有效，激光组和钻孔组分别有82.6%和75.3%的患者气骨间隙缩小至10dB以内。接受二氧化碳激光手术的患者耳鸣发生率显著较低。激光组术中及术后并发症的发生率显著较低。所有参数的差异均具有统计学意义（p<0.05）。
基于术后听力改善程度、耳鸣情况及并发症发生率，可以得出结论，在镫骨足板翻起术过程中使用二氧化碳激光是一种有效且安全的方法，这为推广其在耳硬化症手术治疗中的应用提供了依据。
