Al-Qudah M, Dawes P J D
Department of ORL-HNS, Division of Medical and Surgical Sciences, University of Otago, Dunedin, New Zealand.
J Laryngol Otol. 2006 Sep;120(9):736-9. doi: 10.1017/S002221510600168X. Epub 2006 Jun 2.
Tympanoplasty is often a necessary part of middle-ear surgery, the most common defect being that between an intact, mobile stapes and the malleus handle. The most readily available tissue is the patient's incus, reshaped to bridge the space between an intact stapes and the malleus. When the incus cannot be used, the hydroxyapatite Wehrs incus prosthesis can be used as an alternative.Twenty-six patients had an autograft incus ossiculoplasty and 20 patients underwent modified Wehrs incus prosthesis ossiculoplasty. The average post-operative air-bone gaps (ABGs) were 16.2 dB hearing loss (dBHL) and 17.2 dBHL, respectively. Air-bone gap closure to within 15 dBHL was achieved for 48 per cent of incus autografts and for 57 per cent of Wehrs prostheses, and to within 20 dBHL for 77 per cent and 62 per cent, respectively. Over four years follow up, the reconstruction was stable for each group, the ABGs being 17.7 dBHL and 17.1 dBHL, respectively.
鼓室成形术通常是中耳手术的必要组成部分，最常见的缺损是完整、可活动的镫骨与锤骨柄之间的缺损。最容易获取的组织是患者自身的砧骨，将其重塑以桥接完整的镫骨与锤骨之间的间隙。当无法使用砧骨时，可使用羟基磷灰石韦尔斯砧骨假体作为替代。26例患者接受了自体砧骨听骨成形术，20例患者接受了改良韦尔斯砧骨假体听骨成形术。术后平均气骨间隙（ABG）分别为听力损失16.2 dB（dBHL）和17.2 dBHL。48%的自体砧骨移植和气骨间隙缩小至15 dBHL以内，57%的韦尔斯假体达到此效果；分别有77%和62%的患者气骨间隙缩小至20 dBHL以内。经过四年的随访，每组的重建情况都很稳定，气骨间隙分别为17.7 dBHL和17.1 dBHL。
