Kujala Juuso, Aalto Heikki, Ramsay Hans, Hirvonen Timo P
Department of Otorhinolaryngology, Seinäjoki Central Hospital, Seinäjoki, Finland.
Acta Otolaryngol. 2008 Apr;128(4):347-51. doi: 10.1080/00016480701749257.
The patients recovered from the surgery as after unilateral surgery. The success rate for hearing improvement was good both subjectively and objectively, and this was also displayed in the quality of life. According to our study, simultaneous bilateral stapes surgery can be performed safely in selected patients with bilateral conductive hearing loss.
Otosclerosis is bilateral in the majority of patients. In this study we evaluated the outcome of simultaneous bilateral stapes surgery.
Eighteen patients suffering from bilateral otosclerosis or osteogenesis imperfecta were prospectively included. After operation, hearing and vestibular function were followed by audiometry and visual feedback posturography (VFP). Patients estimated their hearing gain, the intensity of vestibular symptoms and quality of life score with a questionnaire during the follow-up period of 1 year.
The mean improvement in pure-tone average (PTA) air conduction (PTA-AC) was 18 dB (range 1-41 dB). The mean air-bone gap (AB-GAP) diminished from 22 dB (range 10-41 dB) to 7 dB on both sides (range 0-18 dB). The mean preoperative score of 2.3 for hearing improved significantly to 4.1 (p<0.001). Vestibular symptoms were mild and temporary. The VFP was not permanently impaired in any of the patients. The quality of life score improved significantly from 3.4 to 1.3 postoperatively (p<0.001).
患者术后恢复情况与单侧手术术后相同。听力改善的成功率在主观和客观方面均良好，生活质量也有所体现。根据我们的研究，对于部分双侧传导性听力损失患者，可安全地进行双侧镫骨手术。
大多数耳硬化症患者为双侧患病。本研究评估了双侧镫骨同期手术的效果。
前瞻性纳入18例双侧耳硬化症或成骨不全患者。术后，通过听力测定和视觉反馈姿势描记法（VFP）对听力和前庭功能进行跟踪。在1年的随访期内，患者通过问卷评估听力改善情况、前庭症状强度及生活质量评分。
纯音平均气导（PTA-AC）平均改善18 dB（范围1 - 41 dB）。双侧气骨导间距（AB-GAP）平均从22 dB（范围10 - 41 dB）减小至7 dB（范围0 - 18 dB）。听力术前平均评分为2.3，术后显著提高至4.1（p<0.001）。前庭症状轻微且为暂时性。所有患者的VFP均未受到永久性损害。生活质量评分术后从3.4显著提高至1.3（p<0.001）。
