University of Miami Miller School of Medicine, Miami, FL, USA.
Am J Otolaryngol. 2010 Jul-Aug;31(4):235-40. doi: 10.1016/j.amjoto.2009.02.014. Epub 2009 May 17.
The purpose of this study is to identify prognostic factors affecting outcome in ossicular chain reconstruction (OCR).
This study is a retrospective case series of electronic database at an academic institution.
We reviewed 209 cases of chronic supportive otitis media performed from January 2000 through December 2007 and collected demographic, clinical, audiologic, and outcome information. Univariate analyses of group differences in terms of postoperative air-bone gap (ABG) changes were evaluated by analysis of variance. Multiple regression analyses were used to examine the relationship between postoperative ABG and the independent variables.
There were 105 cases of OCR the met the inclusion criteria (44 primary and 61 revision tympanoplasties), with an average follow-up of 19 months. The diagnoses were chronic suppurative otitis media without cholesteatoma in 36 cases and cholesteatoma in 69 cases. The mean preoperative ABG was 34 +/- 15 dB, and the mean postoperative ABG was 20 +/- 14 dB (P < 0.001). Of the independent variables analyzed, the type of procedure (ie, OCR performed during second-look tympanoplasty vs canal wall up vs canal wall down), preoperative ABG, and status of malleus handle were predictive of the success of OCR.
Favorable prognostic factors in OCR include smaller preoperative ABG and the presence of an intact malleus handle.
本研究旨在确定影响听骨链重建（ossicular chain reconstruction，OCR）预后的因素。
这是一项回顾性病例系列研究，在学术机构的电子数据库中进行。
我们回顾了 2000 年 1 月至 2007 年 12 月期间进行的慢性支持性中耳炎的 209 例病例，并收集了人口统计学、临床、听力和结果信息。通过方差分析评估了术后气骨导差（air-bone gap，ABG）变化的组间差异的单变量分析。使用多元回归分析来检查术后 ABG 与独立变量之间的关系。
符合纳入标准的 OCR 有 105 例（44 例为原发性，61 例为翻修性鼓室成形术），平均随访时间为 19 个月。诊断为无胆脂瘤的慢性化脓性中耳炎 36 例，胆脂瘤 69 例。术前 ABG 平均为 34±15dB，术后 ABG 平均为 20±14dB（P<0.001）。在分析的独立变量中，手术类型（即二期鼓室成形术中进行的 OCR、上鼓室切开术和下鼓室切开术）、术前 ABG 和锤骨柄状态是 OCR 成功的预测因素。
OCR 的有利预后因素包括较小的术前 ABG 和完整的锤骨柄。
