Babighian G, Amadori M, Galaverni G, de Min G
Divisione di Otorinolaringoiatria e Centro Reg., di Audiologia Ospedali, Civili di Venezia.
An Otorrinolaringol Ibero Am. 1991;18(3):239-48.
Extreme stapedectomy is an operation aimed at restoring a serviceable hearing in patients affected by far-advanced otosclerosis with profound hearing loss. Surgery is performed on the understanding that the hearing aid will still be needed after the operation. Therefore, patient's expectations should be confined to possibly improved performance with a hearing aid as a consequence of the operation. Clinical as well as audiological preoperative assessment must be very rigorous. Counselling is mandatory and a trial period with a hearing aid is strongly advisable. Our experience is based on 15 cases, operated on between 1984 and 1988. A small fenestra technique was performed using wire-teflon piston prostheses. Results were satisfactory and in accordance with the ratio of the procedure in 8 cases (53%). 7 patients (47%) yielded an unsuccessful outcome and 2 of them had a dead ear (13%). This high rate of labyrinthine failure, the improvement in hearing aids and cochlear implants technologies well are likely to reduce the number of potential candidates for an extreme stapedectomy. However, this operation should be still kept in the otologist's armamentarium as a possible option in borderline cases.
极限镫骨切除术是一种旨在为患有晚期耳硬化症且听力严重丧失的患者恢复可用听力的手术。该手术基于这样一种认识，即术后仍需使用助听器。因此，患者的期望应仅限于手术可能会使助听器的使用效果得到改善。临床和听力学术前评估必须非常严格。咨询是必不可少的，强烈建议进行助听器试用。我们的经验基于1984年至1988年间进行手术的15例病例。采用钢丝-聚四氟乙烯活塞假体进行小开窗技术。8例（53%）的结果令人满意且符合该手术的成功率。7例患者（47%）手术结果不佳，其中2例出现全聋（13%）。这种较高的迷路衰竭率、助听器和人工耳蜗植入技术的改进，很可能会减少极限镫骨切除术潜在候选者的数量。然而，作为临界病例的一种可能选择，这种手术仍应保留在耳科医生的手术方法中。
