Wu Peina, Ge Runmei, Wang Zhengmin, Wang Xiaoqian, Meng Cuiyuan, Cui Yong, Fu Min, Chen Liangsi
Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangzhou, 510080, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Sep;21(17):791-3.
To evaluate the feasibility, safety and effectiveness of malleostapedotomy based on malleus-oval window technique in otosclerosis with malleus/incus mobility disorder.
Six cases with malleostapedotomy on stapes footplate fixation accompanied by malleus/incus movements disorder from March 2005 to March 2007 were analyzed retrospectively, when totally 78 cases of conventional stapes surgeries were performed on isolated otosclerosis . The surgical procedures, intraoperative findings and postoperative vertigo as well as pure tone gain were discussed.
All of the 6 cases showed stapes footplate fixation. Both abnormal incudomalleolar joint and incudostapedial joint were found in 2 cases. It was suspected that previous inflammation resulted in yellowish mucosa, ossicular malformation and stiffness. The third one showed local tympanosclerosis in the attic. In another 2 cases, idiopathic malleus head fixation related to the anterior and superior mallear ligament abnormal were presented while a surgical incudomalleolar joint dislocation prior to the observation happened in the last one. Among these 6 cases, there was no 4.0 Hz notch and postoperative vertigo which needs a further care. Postoperative air-bone gap on 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz averaged less than 10 dB. All the patients had been followed up for 3 months.
Malleostapedotomy based on malleus-oval window technique is a safe and effective procedure available for otosclerosis with malleus/incus movement disorder from different origins.
评估基于锤骨-卵圆窗技术的镫骨足板切除术治疗镫骨固定伴锤骨/砧骨活动障碍耳硬化症的可行性、安全性和有效性。
回顾性分析2005年3月至2007年3月期间6例镫骨足板固定伴锤骨/砧骨活动障碍行镫骨足板切除术的患者，同期共78例孤立性耳硬化症患者接受了传统镫骨手术。讨论手术过程、术中发现、术后眩晕情况以及纯音增益。
6例患者均表现为镫骨足板固定。2例患者同时存在砧镫关节和砧锤关节异常。怀疑既往炎症导致黏膜发黄、听骨链畸形和僵硬。第3例患者上鼓室局部鼓膜硬化。另外2例患者表现为特发性锤骨头固定，与锤骨前上韧带异常有关，最后1例患者在观察前发生手术性砧锤关节脱位。这6例患者中，无4.0 Hz切迹及需要进一步处理的术后眩晕。术后0.5 kHz、1.0 kHz、2.0 kHz、4.0 kHz气骨导差平均小于10 dB。所有患者均随访3个月。
基于锤骨-卵圆窗技术的镫骨足板切除术是一种安全有效的手术方法，可用于治疗不同病因的镫骨固定伴锤骨/砧骨活动障碍耳硬化症。
