Hales Nathan W, Shakir Faiz A, Saunders James E
Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Am J Otolaryngol. 2007 May-Jun;28(3):164-7. doi: 10.1016/j.amjoto.2006.08.005.
Several articles have demonstrated the efficacy of titanium middle ear prostheses. Our study compares the results of 2 brands of titanium implants that differ in design and weight to assess potential benefit of one over the other. The purpose of this study was to investigate the relationship of prostheses mass based on the stiffness vs mass curve of acoustic transfer between 2 different brands of titanium implants.
A retrospective study was done for this article.
A chart review was conducted including the postoperative results, complications, and audiometric data for 34 patients with titanium middle ear implants (21 Tuebingen VARIO prostheses [Kurz Co, DuBlingen, Germany] and 13 Micron Monolithic prostheses [Gyrus ENT, Bartlett, TN]) with an average follow-up of 19 months. Both total and partial prostheses were included. Average postoperative air-bone gap (ABG) and average improvement in ABG was compared between the groups.
There was a considerable variability in the postoperative results with both implants. Both the Kurz prostheses (group A) and the Gyrus prostheses (group B) demonstrated an average postoperative ABG of less than 25 dB (23.2 and 21.3 dB). There was no significant difference between the groups. Both groups also demonstrated an improvement in average ABG (preoperative minus postoperative ABG), 9.6 and 11.2 dB. There was no significant difference between the 2 prosthesis types in the frequency-specific ABG (500, 1000, 2000, and 4000 Hz). Both groups demonstrated maximal resonant frequency at 2000 Hz. The extrusion rates (5% and 8%) were comparable between the groups.
Factors other than the prosthesis design (eg, surgical technique, fibrosis, retraction, and cholesteatoma) primarily determine hearing results after staged ossiculoplasty. The differences we noted in frequency-specific hearing improvement do not demonstrate that the mass of the prostheses plays a significant role in outcome.
多篇文章已证明钛质中耳假体的疗效。我们的研究比较了两种设计和重量不同的钛质植入物的结果，以评估其中一种相对于另一种的潜在优势。本研究的目的是根据两种不同品牌钛质植入物之间声传递的刚度与质量曲线，研究假体质量之间的关系。
本文进行了一项回顾性研究。
对34例钛质中耳植入患者（21例图宾根VARIO假体[德国杜布林根库尔兹公司]和13例微米整体式假体[美国田纳西州巴特利特吉鲁斯耳鼻喉科公司]）的术后结果、并发症和听力数据进行了图表回顾，平均随访19个月。全假体和部分假体均包括在内。比较两组之间的平均术后气骨间隙（ABG）和ABG的平均改善情况。
两种植入物的术后结果存在相当大的差异。库尔兹假体（A组）和吉鲁斯假体（B组）的术后平均ABG均小于25dB（分别为23.2dB和21.3dB）。两组之间无显著差异。两组的平均ABG（术前减去术后ABG）也均有改善，分别为9.6dB和11.2dB。两种假体类型在特定频率的ABG（500、1000、2000和4000Hz）方面无显著差异。两组的最大共振频率均为2000Hz。两组之间的挤出率（分别为5%和8%）相当。
分期听骨链成形术后的听力结果主要由假体设计以外的因素（如手术技术、纤维化、回缩和胆脂瘤）决定。我们在特定频率听力改善方面注意到的差异并未表明假体质量在结果中起重要作用。
