Toner J C, Smyth G D, Kerr A G
Eye and Ear Clinic, Royal Victoria Hospital, Belfast, N. Ireland.
J Laryngol Otol. 1991 Jul;105(7):529-33. doi: 10.1017/s0022215100116524.
The results of ossiculoplasty are frequently reported in terms of closure of the air-bone gap. This parameter is a reliable indicator of the degree of technical success, and is useful in comparing different materials and types of reconstructions. However, assessment of the operated ear alone does not evaluate the effect of surgery on binaural hearing ability, leading to the situation where sub-optimal advice may be given to patients pre-operatively. This article advocates a more patient orientated method of assessing the results of ossiculoplasty. Previous studies have indicated that the operated ear must reach an air conduction level of 30 dB for the speech frequencies, or be within 15 dB of the other ear, to ensure that the patient will gain significant benefit. A graphical method for the prediction of patient benefit is presented, and compared to the rule of thumb quoted above. The implications for surgeons and patients considering ossiculoplasty are obvious. Many statements routinely made to patients prior to surgery for conductive hearing loss are unduly optimistic and unrelated to the realities of reported results. There is a need to determine what types of such hearing losses can be helped surgically, and more importantly to what extent the patients hearing disability can be relieved.
听骨成形术的结果通常依据气骨导差的缩小情况来报告。该参数是技术成功程度的可靠指标，有助于比较不同材料和重建类型。然而，仅对手术耳进行评估并不能评价手术对双耳听力能力的影响，这就导致术前可能会给患者提供不够理想的建议。本文提倡一种更以患者为导向的听骨成形术结果评估方法。先前的研究表明，手术耳在言语频率下的气导水平必须达到30分贝，或者与对侧耳相差不超过15分贝，才能确保患者获得显著益处。本文提出了一种预测患者获益的图表方法，并与上述经验法则进行了比较。这对外科医生和考虑进行听骨成形术的患者的意义显而易见。在传导性听力损失手术前，许多经常对患者说的话过于乐观，且与报告结果的实际情况无关。有必要确定哪些类型的此类听力损失可以通过手术得到改善，更重要的是患者的听力残疾能在多大程度上得到缓解。
