Ghonim M R, Shabana Y K, Elkotb M Y
Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Egypt.
J Laryngol Otol. 2011 May;125(5):441-4. doi: 10.1017/S0022215110002264. Epub 2010 Nov 5.
This study aimed to use a new otological technique, malleus relocation, to solve the problems of ossicular reconstruction undertaken during revision stapes surgery for incus necrosis.
Prospective study of 12 patients undergoing revision stapedectomy for incus necrosis, in the otolaryngology department of Mansoura University, Egypt.
Twelve patients underwent ossiculoplasty between June 2004 and June 2007, as part of revision surgery for otosclerosis with incus necrosis. All patients underwent ossiculoplasty using the malleus relocation technique. Ossiculoplasty used the patient's own, necrosed incus between the relocated malleus and the footplate.
Post-operative air-bone gap closure to within 10 dB was achieved in seven patients (58.3 per cent). An air-bone gap of less than 20 dB was obtained in 10 patients (83.3 per cent). Deterioration of bone conduction by 10 dB occurred in one case. No patients were left with a 'dead ear'. Patients' hearing was stable throughout the follow-up period (range six to 40 months; mean ± standard deviation 23.5 ± 12.8 months).
These findings indicate that malleus relocation, performed during revision stapes surgery, is a safe and efficient technique for the treatment of incus necrosis.
本研究旨在运用一种新的耳科技术——锤骨重新定位术,解决镫骨手术翻修时因砧骨坏死而进行的听骨链重建问题。
对埃及曼苏拉大学耳鼻喉科12例行砧骨坏死镫骨手术翻修的患者进行前瞻性研究。
2004年6月至2007年6月期间,12例患者接受了听骨链成形术,作为耳硬化症伴砧骨坏死翻修手术的一部分。所有患者均采用锤骨重新定位技术进行听骨链成形术。听骨链成形术利用患者自身已坏死的砧骨,置于重新定位的锤骨与镫骨足板之间。
7例患者(58.3%)术后气骨导差缩小至10 dB以内。10例患者(83.3%)气骨导差小于20 dB。1例患者骨导下降10 dB。无一例患者遗留“死耳”。在整个随访期(6至40个月;平均±标准差23.5±12.8个月)内患者听力稳定。
这些研究结果表明,在镫骨手术翻修时进行锤骨重新定位术,是治疗砧骨坏死的一种安全有效的技术。