Zuur C L, de Bruijn A J G, Lindeboom R, Tange R A
Department of Otolaryngology-Head and Neck Surgery, Academical Medical Center, University of Amsterdam, The Netherlands.
Otol Neurotol. 2003 Nov;24(6):863-7. doi: 10.1097/00129492-200311000-00006.
To evaluate the early postoperative hearing results of a new titanium stapes prosthesis (K-Piston) implanted in patients with otosclerosis.
A retrospective analysis of preoperative and early postoperative hearing thresholds.
One tertiary referral and teaching hospital.
Eighteen men and 40 women, mean age 47 years, with otosclerosis.
Primary stapedotomy.
Main outcome measures were the mean gains in bone-conduction and air-conduction pure-tone thresholds, and pure-tone averages for different frequency combinations. Success and failure of the individual cases were presented using Amsterdam Hearing Evaluation Plots.
The overall postoperative air-bone gap for the frequency combination 0.5-1-2-4 kHz was 8.4 (standard deviation: 5.2) dB. In 79% of the patients the postoperative air-bone gap was less than 10 dB. Air-conduction improved even in higher frequencies, while the Carhart effect was not seen in most cases. In three patients a deterioration of bone-conduction was observed ranging from 11 to 16 dB sound pressure level (SPL), and in four patients the gain in air-conduction was insufficient (3-29 dB SPL) to close the preoperative air-bone gap to within 20 dB.
The new low-weight, full-titanium stapes prosthesis with its slight rough surface and its good mechanical stability and biocompatibility can safely and successfully restore the function of the middle ear when implanted in patients with otosclerosis.
评估新型钛质镫骨假体（K型活塞）植入耳硬化症患者后的早期术后听力结果。
对术前和术后早期听力阈值进行回顾性分析。
一家三级转诊和教学医院。
18名男性和40名女性，平均年龄47岁，患有耳硬化症。
初次镫骨切除术。
主要观察指标为骨导和气导纯音阈值的平均改善情况，以及不同频率组合的纯音平均值。使用阿姆斯特丹听力评估图展示个体病例的成功与失败情况。
频率组合为0.5-1-2-4kHz时，术后总体气骨导差为8.4（标准差：5.2）dB。79%的患者术后气骨导差小于10dB。即使在高频段气导也有所改善，且多数情况下未观察到卡哈特效应。3例患者骨导恶化，声压级下降11至16dB，4例患者气导改善不足（3至29dB SPL），无法将术前气骨导差缩小至20dB以内。
新型低重量、全钛镫骨假体表面略有粗糙，具有良好的机械稳定性和生物相容性，植入耳硬化症患者后能够安全、成功地恢复中耳功能。
