Thomeer Henricus G X M, Kunst Henricus P M, Cremers Cor W R J
Department of Otorhinolaryngology, Donders Institute for Neuroscience, Radboud University Medical Centre, Nijmegen, the Netherlands.
Arch Otolaryngol Head Neck Surg. 2011 Sep;137(9):935-41. doi: 10.1001/archoto.2011.137.
To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly.
A retrospective analysis of charts collected between 1986 and 2001.
A tertiary referral center.
A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction.
Audiometric results.
Overall, a mean gain in air conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative air-bone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of air conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears.
Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impairment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.
描述一系列镫骨足板固定合并其他听骨链中耳畸形患者行镫骨手术后的听力测试结果。
对1986年至2001年间收集的病历进行回顾性分析。
一家三级转诊中心。
共有25例患者（30耳）接受了探查性鼓室切开术和听骨链重建术。
听力测试结果。
总体而言，观察到气导平均增益为18dB（从49dB降至31dB），术后平均气骨导间距（ABG）为20dB（术前平均ABG为40dB）。70%的病例ABG闭合小于或等于20dB，这与文献报道的少数结果一致。此外，听力测试结果保持稳定。在有综合征的耳组中，气导平均增益仅为19dB，与非综合征耳中观察到的结果相当。
先天性镫骨足板固定合并听骨链异常的手术可带来有价值的听力改善。30耳中有21耳（70%）的ABG闭合小于或等于20dB。大多数耳有一定程度的感音神经性损害（10 - 20dB），这影响了术后的最终听力水平。近几十年来，锤骨 - 镫骨切除术技术有所改进。对于综合征诊断，术前评估是必需的，这对患者咨询和预后可能很重要。
