Thiel G, Mills R
Otolaryngology Unit, University of Edinburgh, Scotland, UK.
J Laryngol Otol. 2011 May;125(5):460-6. doi: 10.1017/S0022215110002422. Epub 2010 Dec 9.
Stapedotomy produces the best hearing results of any otological operation. However, in a small number of cases the air-bone gap is not successfully closed, or conductive hearing loss recurs.
To investigate the proportion of cases in the senior author's series which required revision surgery and to determine the medium to long term success rate of surgery, taking into account the results of revision surgery.
Review of a series of 233 primary stapedotomy operations and 100 revision procedures carried out by one surgeon over a 20-year period.
Closure of the air-bone gap to within 10 dB was achieved in 80 per cent of cases following the primary procedure. Fifteen per cent of patients developed a recurrence of conductive hearing loss. When the results of revision surgery were taken into account, the proportion of ears with a mean air-bone gap of less than 10 dB was 86 per cent. However, of the patients undergoing revision surgery, air-bone gap closure to within 10 dB was only achieved in 52 per cent of cases.
The best chance of obtaining a successful outcome in stapedotomy is to achieve this for the first procedure. However, revision surgery does increase the medium to long term success rate.
在所有耳科手术中，镫骨切除术的听力改善效果最佳。然而，在少数病例中，气骨导差未能成功消除，或传导性听力损失复发。
在资深作者的病例系列中，调查需要进行翻修手术的病例比例，并考虑翻修手术的结果，确定手术的中长期成功率。
回顾一位外科医生在20年期间进行的一系列233例初次镫骨切除术和100例翻修手术。
初次手术后，80%的病例气骨导差缩小至10 dB以内。15%的患者出现传导性听力损失复发。将翻修手术的结果考虑在内，平均气骨导差小于10 dB的耳朵比例为86%。然而，在接受翻修手术的患者中，只有52%的病例气骨导差缩小至10 dB以内。
镫骨切除术获得成功结果的最佳机会是在首次手术时实现。然而，翻修手术确实提高了中长期成功率。
