Giddings N A, House J W
Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center.
Otolaryngol Head Neck Surg. 1992 Nov;107(5):644-50. doi: 10.1177/019459989210700506.
When tympanosclerosis involves the tympanic membrane or the lateral ossicles, treatment is usually straightforward and uncomplicated. When the stapes is involved, therapy is more controversial and may be more difficult. We report our results in 154 patients who underwent different surgical procedures for tympanosclerosis of the stapes. Followup was up to 10 years. Pure-tone average threshold was significantly improved (p < 0.05) in patients who underwent mobilization procedures or stapedectomy for definitive treatment. The air-bone gap was less than 20 dB at 6 months postoperative in 72% of patients and less than 30 dB in 90%. At 6 months, 2 years, and 5 years there were no statistically significant differences in hearing results between stapedectomy and mobilization patients, some of whom were followed for up to 10 years. No patient had a profound hearing loss after surgery. Surgical treatment for tympanosclerosis of the stapes is a safe procedure, with hearing results similar to those of surgery for other chronic ear diseases involving the ossicular chain.
当鼓室硬化症累及鼓膜或外侧听小骨时，治疗通常简单直接且不复杂。当镫骨受累时，治疗则更具争议性且可能更困难。我们报告了154例因镫骨鼓室硬化症接受不同手术治疗的患者的结果。随访时间长达10年。接受松动手术或镫骨切除术进行确定性治疗的患者，纯音平均阈值有显著改善（p<0.05）。术后6个月时，72%的患者气骨导差小于20dB，90%的患者小于30dB。在6个月、2年和5年时，镫骨切除术患者与松动手术患者的听力结果无统计学显著差异，其中一些患者随访长达10年。术后无患者出现重度听力损失。镫骨鼓室硬化症的手术治疗是一种安全的手术，听力结果与涉及听骨链的其他慢性耳部疾病的手术相似。
