Zaki Z, Wiener V, Corré A, Ayache D
Fondation Adolphe de Rothschild, Service ORL, l'Unité d'Otologie Otoneurologie, Paris, France.
Rev Laryngol Otol Rhinol (Bord). 2006;127(3):127-30.
The aim of this study was to report a series of patients with far-advanced otosclerosis who were unable to benefit from hearing aids. Among patients with profound hearing loss, it is particularly useful to diagnose far-advanced otosclerosis even if relatively rare, because stapes surgery can improve hearing to a level allowing conventional hearing aid use (sometime the only choice before cochlear implant).
We retrospectively reviewed the charts of 7 patients (9 operated ears) in order to highlight diagnostic criteria, surgical indications and results of stapes surgery (stapedectomy or stapedotomy).
Diagnosis of far-advanced otosclerosis was based on clinical presentation, course of hearing loss, positive family history of otosclerosis, and results of CT scan which was helpful in all the cases. Obliterative otosclerosis was found in 55% of the cases. Success of stapes surgery was observed in 89%, with no significant difference between stapedectomy or stapedotomy.
Although rare, far-advanced otosclerosis must be diagnosed because patients can benefit from stapes surgery (and subsequently fitting of appropriate hearing aids).
本研究旨在报告一系列极重度耳硬化症患者,这些患者无法从助听器中获益。在重度听力损失患者中,即使极重度耳硬化症相对罕见,但诊断它仍特别有用,因为镫骨手术可将听力提高到能使用传统助听器的水平(有时这是人工耳蜗植入前的唯一选择)。
我们回顾性分析了7例患者(9只手术耳)的病历,以突出镫骨手术(镫骨切除术或镫骨造孔术)的诊断标准、手术指征及结果。
极重度耳硬化症的诊断基于临床表现、听力损失病程、耳硬化症家族史阳性以及CT扫描结果,CT扫描在所有病例中均有帮助。55%的病例发现有闭塞性耳硬化症。镫骨手术成功率为89%,镫骨切除术和镫骨造孔术之间无显著差异。
尽管极重度耳硬化症罕见,但必须对其进行诊断,因为患者可从镫骨手术(以及随后佩戴合适的助听器)中获益。