Quaranta Nicola, Besozzi Gaspare, Fallacara Rosa Anna, Quaranta Antonio
Otorhinolaryngology Clinic G. Lugli, Otologic and Neurotologic Surgery, Department of Ophthalmology and Otorhinolaryngology, University of Bari, Italy.
Otolaryngol Head Neck Surg. 2005 Jul;133(1):116-20. doi: 10.1016/j.otohns.2005.03.011.
The aim of this study was to analyze and compare the results obtained in otosclerosis patient undergoing stapedotomy and partial stapedectomy.
Retrospective review of surgical series. The guidelines of the American Academy of Otolaryngology-Head and Neck Surgery for the evaluation of results of treatment of conductive hearing loss were used.
Pure tone average (0.5 to 3 kHz) air-bone gap was 6.1 dB in the partial stapedectomy and 6 dB in the stapedotomy group. The air-bone gap (ABG) closure rate did not differ between the 2 groups, except at 4 kHz, where stapedotomy group showed greater closure (P 0.003). Mean postoperative ABG gain was significantly (P < 0.05) higher in the stapedotomy group at 2, 3, and 4 kHz. Mean postoperative air-conduction gain did not differ significantly. Mean postoperative bone conduction (BC) change (1, 2, and 4 kHz) was 3.68 dB in partial stapedectomy and -0.02 dB in stapedotomy group, the difference being significant (P 0.007). Differences in BC change between the 2 groups were significant at each frequency.
Similar good results can be obtained in experienced hands using either partial stapedectomy or stapedotomy technique. ABG closure rates were analogous in the 2 techniques as well as the complication rate. Although stapedotomy obtain better results at high frequencies, partial stapedectomy is associated with increased BC threshold at all frequencies.
本研究旨在分析和比较镫骨切除术和部分镫骨切除术治疗耳硬化症患者的结果。
手术系列的回顾性研究。采用美国耳鼻咽喉头颈外科学会评估传导性听力损失治疗结果的指南。
部分镫骨切除术组纯音平均听阈(0.5至3kHz)气骨导差为6.1dB,镫骨切除术组为6dB。除4kHz外,两组气骨导差(ABG)闭合率无差异,镫骨切除术组在4kHz时闭合率更高(P = 0.003)。镫骨切除术组在2、3和4kHz时术后平均ABG增益显著更高(P < 0.05)。术后平均气导增益无显著差异。部分镫骨切除术组术后平均骨导(BC)变化(1、2和4kHz)为3.68dB,镫骨切除术组为-0.02dB,差异显著(P = 0.007)。两组在各频率下的BC变化差异均显著。
经验丰富的医生采用部分镫骨切除术或镫骨切除术技术均可取得相似的良好效果。两种技术的ABG闭合率及并发症发生率相似。虽然镫骨切除术在高频时效果更好,但部分镫骨切除术在所有频率下均与BC阈值升高相关。