Vick U, Just T, Terpe H, Graumüller S, Pau H W
Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie "Otto Körner" der Universität Rostock.
HNO. 2004 Dec;52(12):1076-82. doi: 10.1007/s00106-003-1032-6.
The audiometric results after stapes surgery in children with isolated stapes footplate fixation were reason enough to analyze intraoperative findings and surgical procedures.
PATIENTS/METHODS: A total of 438 stapes surgeries were performed in the years 1985-2000, and a retrospective analysis was made of the anamnestic data, intraoperative findings and audiometric data from 12 children with isolated fixation of the stapes footplate. The average age of the children when operated was 10.2 years (the youngest was 7 and the eldest 13). A loss of hearing had set in 5 years earlier.
Taking the anamnestic data and the intraoperative into account, otosclerosis was found in 5 children. One child had a narrow oval window niche, in a further six children a congenital fixation of the stapes footplate was evident. Only 58% (n=7) of the 12 children operated showed acceptable postoperative hearing results. The best hearing results were found in children with juvenile otosclerosis. In three of six children with congenital stapes fixation, a worsening of both bone and air conduction was evident. The average conductive hearing loss was 30 dB at 1, 2 and 4 kHz.
When explorative tympanotomy is indicated, a thin-layer CT scan of the temporal bone should be made to assess the risk of a liquor pressure labyrinth developing.
孤立性镫骨足板固定患儿行镫骨手术后的听力测定结果足以促使我们分析术中发现及手术操作。
患者/方法：1985年至2000年间共进行了438例镫骨手术，对12例孤立性镫骨足板固定患儿的既往资料、术中发现及听力测定数据进行回顾性分析。手术时患儿的平均年龄为10.2岁（最小7岁，最大13岁）。听力损失在5年前就已出现。
综合既往资料及术中情况，5例患儿发现有耳硬化症。1例患儿卵圆窗龛狭窄，另有6例患儿镫骨足板先天性固定明显。接受手术的12例患儿中仅有58%（n = 7）术后听力结果可接受。青少年耳硬化症患儿听力结果最佳。6例先天性镫骨固定患儿中有3例骨导和气导均明显恶化。1、2和4kHz处平均传导性听力损失为30dB。
当需要进行探查性鼓室切开术时，应进行颞骨薄层CT扫描以评估发生脑脊液压力性迷路炎的风险。
