Somers Thomas, Vercruysse Jean-Philippe, Zarowski Andrzej, Verstreken Margriet, Offeciers Erwin
Department of Otorhinolaryngology, Saint Augustine Hospital, Antwerp, Belgium.
Ann Otol Rhinol Laryngol. 2006 Dec;115(12):880-5; discussion 886. doi: 10.1177/000348940611501203.
A prospective randomized audiological analysis of 336 otosclerosis operations was conducted to compare the evolution of bone conduction thresholds after primary stapedotomy with two different techniques to open the footplate: microdrill and carbon dioxide laser stapedotomy.
To monitor the inner ear function, we compared the preoperative bone conduction thresholds with the postoperative levels at day 2, week 2, week 6, and month 6. Evolution of the bone conduction was compared for the two studied groups (laser versus microdrill).
An average bone conduction loss of 1.8 dB was measured at day 2 for the middle frequencies (0.5, 1, and 2 kHz). At 4 kHz, a bone conduction loss of 7 dB was found. The bone conduction thresholds measured in the first and second months after surgery showed a gradual recovery with overclosure as the end result.
Our results confirm the transient depression of inner ear function in the immediate postoperative period, with recovery within the first weeks after surgery. In the studied population, no statistically significant difference was found between the two techniques that were used to make the calibrated hole (laser versus microdrill). These results demonstrate that both techniques possess the same early effect regarding inner ear function. The authors hypothesize that an early inflammatory reaction could be the cause of the transient bone conduction shift.
对336例耳硬化症手术进行前瞻性随机听力学分析，比较采用两种不同技术打开镫骨足板的一期镫骨切开术后骨导阈值的变化情况，这两种技术分别是微型钻头和二氧化碳激光镫骨切开术。
为监测内耳功能，我们比较了术前骨导阈值与术后第2天、第2周、第6周和第6个月时的骨导阈值水平。比较了两个研究组（激光组与微型钻头组）骨导的变化情况。
术后第2天，中频（0.5、1和2kHz）平均骨导损失为1.8dB。在4kHz时，发现骨导损失为7dB。术后第1个月和第2个月测得的骨导阈值显示逐渐恢复，最终结果是超闭合。
我们的结果证实了术后即刻内耳功能的短暂下降，并在术后第一周内恢复。在研究人群中，用于制作校准孔的两种技术（激光与微型钻头）之间未发现统计学上的显著差异。这些结果表明，两种技术对内耳功能具有相同的早期影响。作者推测早期炎症反应可能是骨导短暂偏移的原因。
