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氩激光辅助小窗镫骨切除术治疗耳硬化症

Argon laser assisted small fenestra stapedotomy for otosclerosis.

作者信息

Raut Vivek, Halik Jerry

机构信息

New Cross Hospital, Wednesfield Road, Wolverhampton WV10 0QP, UK.

出版信息

Auris Nasus Larynx. 2005 Mar;32(1):11-5. doi: 10.1016/j.anl.2004.11.013. Epub 2005 Apr 7.

Abstract

To report and analyse our results and complications of argon laser assisted stapedotomy for primary otosclerosis. A retrospective analysis of 135 consecutive cases of primary otosclerosis operated by the senior author (JH) has been performed. The air-bone gap was calculated by using the pure tone average at 500, 1000, 2000 and 4000 Hz. A separate analysis of air-bone gap at 500, 1000 and 2000 Hz was carried out to assess the effects of a small diameter piston on low frequency hearing. Hearing at high frequencies (4000 and 8000 Hz) was also assessed to evaluate effects of small fenestra technique on high frequency hearing. Preservation of cochlear function was assessed by comparing the average pre- and post-operative bone conduction thresholds. Complications arising were analysed. The post-operative air-bone gap at 0.5, 1 and 2 kHz was 10 dB or less in 85.19% of patients and 20 dB or less in 97.04% patients. The air-bone gap at 0.5-4 kHz was <or=10 dB in 77.04% of patients and 20 dB or less in 97.04% patients. The majority of patients showed an improvement at 4 kHz (81.4%) and 8 kHz (60.7%). There was no change in the average pre- and post-operative bone conduction thresholds. There were no major complications. Argon laser reduces mechanical trauma to the vestibule and increases precision resulting in consistent hearing results in all frequencies and reduced post-operative morbidity.

摘要

报告并分析氩激光辅助镫骨切除术治疗原发性耳硬化症的结果及并发症。对资深作者(JH)连续实施的135例原发性耳硬化症手术病例进行了回顾性分析。气骨导差通过使用500、1000、2000和4000赫兹的纯音平均值来计算。对500、1000和2000赫兹的气骨导差进行单独分析,以评估小直径活塞对低频听力的影响。还评估了高频(4000和8000赫兹)听力,以评价小开窗技术对高频听力的影响。通过比较术前和术后平均骨导阈值来评估耳蜗功能的保留情况。对出现的并发症进行了分析。术后0.5、1和2千赫兹的气骨导差在85.19%的患者中为10分贝或更低,在97.04%的患者中为20分贝或更低。0.5至4千赫兹的气骨导差在77.04%的患者中≤10分贝,在97.04%的患者中为20分贝或更低。大多数患者在4千赫兹(81.4%)和8千赫兹(60.7%)时听力有所改善。术前和术后平均骨导阈值没有变化。没有重大并发症。氩激光减少了对内耳前庭的机械损伤,提高了精确性,从而在所有频率上都能获得一致的听力结果,并降低了术后发病率。

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