Elies W, Hermes H
HNO-Klinik der Städtischen Krankenanstalten Bielefeld-Mitte.
HNO. 1990 Feb;38(2):67-70.
The incidence of sensorineural hearing loss after stapedectomy ranges from 0.6% to 5%. There is evidence that reparative granuloma is a major cause: most authors report that it requires urgent surgery, but this view is not universally accepted. This study analyses 14 stapedectomies that resulted in a sudden or gradual sensorineural hearing loss, often combined with vertigo, and presenting between 1 and 6 weeks after an initial hearing improvement. All patients were treated immediately with a combined infusion of an antibiotic, a corticosteroid and a plasma expander. The sensorineural hearing loss began to improve compared with pre-operative values 9 days later. Thus drug therapy might be sufficient in most cases of sensorineural hearing loss early after stapedectomy, and surgery can be restricted to patients with perilymph fistulae.
镫骨切除术后感音神经性听力损失的发生率在0.6%至5%之间。有证据表明修复性肉芽肿是一个主要原因：大多数作者报告称这需要紧急手术，但这一观点并未得到普遍认可。本研究分析了14例导致突然或渐进性感音神经性听力损失的镫骨切除术病例，这些病例常伴有眩晕，且在初次听力改善后1至6周出现。所有患者均立即接受了抗生素、皮质类固醇和血浆扩容剂的联合输注治疗。与术前值相比，9天后感音神经性听力损失开始改善。因此，在镫骨切除术后早期大多数感音神经性听力损失病例中，药物治疗可能就足够了，手术可仅限于有外淋巴瘘的患者。
