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II型听骨链成形术的比较结果:砧骨移位术与钛质部分听骨赝复物(库尔兹)

[Comparative results of type II ossiculoplasty: incus transposition versus titanium PORP (Kurz)].

作者信息

Ceccato S B, Maunsell R, Morata G Celis, Portmann D

机构信息

Médecin stagiaire Institut G. Portmann, Sao Paulo, Brazil.

出版信息

Rev Laryngol Otol Rhinol (Bord). 2005;126(3):175-9.

Abstract

OBJECTIVE

The goal of this study was to compare the anatomical and functional results of two groups of patients having an ossiculoplasty type II, either with the incus, or with a PORP Bell Vario prosthesis (Kurz).

MATERIALS AND METHODS

Retrospective study concerning 98 patients having had an ossiculoplasty type II with the incus (Incus group) and 50 patients having received a PORP titanium prosthesis Bell Vario from Kurz (Titanium group).

RESULTS

The rate of extrusion was small (1% Incus group and 4% Titanium group). Average preoperative air bone gap of patients who received the Titanium prosthesis was 21.2 dB and 42.8 dB for the incus group. The average postoperative air bone gap was 16.9 dB Titanium group and 25.5 dB Incus group (p < 0.05). The gain was 18.7dB in the Incus group and 4.3 dB in Titanium group (p < 0.05). The difference between pre and post air conduction thresholds in both groups was statistically significant (p < 0.05). The post-op airbone gap was less on 20 dB in 62% of cases (Incus group) and 61% (Titanium group). There was no significant loss of the bone conduction thresholds in each group.

CONCLUSION

Audiometric results obtained among patients with an incus transposition are better than those obtained with a PORP Titanium prosthesis. These results are to be appreciated by taking account of the greatest proportion of cholesteatoma and of reoperation in the Titanium group. The PORP titanium Bell Vario prosthesis (Kurz) is a material well tolerated by the middle ear as shown by the low rate extrusion. Its qualities (easy and precise measurement, easy positioning) make a material of choice of it when the patient's incus is not usable.

摘要

目的

本研究的目的是比较两组接受II型听骨链重建术患者的解剖学和功能结果,一组使用砧骨,另一组使用PORP Bell Vario假体(库尔兹公司)。

材料与方法

对98例接受砧骨II型听骨链重建术的患者(砧骨组)和50例接受库尔兹公司PORP钛质假体的患者(钛质组)进行回顾性研究。

结果

移位率较低(砧骨组为1%,钛质组为4%)。接受钛质假体患者的术前平均气骨导差为21.2dB,砧骨组为42.8dB。钛质组术后平均气骨导差为16.9dB,砧骨组为25.5dB(p<0.05)。砧骨组增益为18.7dB,钛质组为4.3dB(p<0.05)。两组术前和术后气导阈值之间的差异具有统计学意义(p<0.05)。术后气骨导差在20dB以下的病例在砧骨组占62%,在钛质组占61%。每组骨导阈值均无明显损失。

结论

砧骨移位患者的听力测量结果优于使用PORP钛质假体的患者。考虑到钛质组胆脂瘤和再次手术的比例更高,这些结果值得重视。PORP钛质Bell Vario假体(库尔兹公司)是一种中耳耐受性良好的材料,移位率较低即表明了这一点。其特性(易于精确测量、易于定位)使其成为患者砧骨无法使用时的首选材料。

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