Ralli Giovanni, Mora Renzo, Nola Giuseppe, Guastini Luca
ENT Department, University of Rome "La Sapienza", Italy.
Acta Otolaryngol. 2012 Jan;132(1):21-6. doi: 10.3109/00016489.2011.619572. Epub 2011 Nov 10.
Stapedotomy is, in our opinion, the technique of choice in stapes surgery. The precision of this technique allows clinicians to perform the surgical procedure in day surgery under local anesthesia.
There is a strong emphasis on increasing the number of elective day surgery cases, especially in the patients' best interest, as it decreases the likelihood of late cancellation and hospital-acquired morbidity. A prospective study was performed to determine whether stapes surgery for otosclerosis could be performed safely in an outpatient setting.
We present a series of stapes surgery cases for otosclerosis performed on a day-case basis. We performed a classic stapedotomy in 9 patients, a reverse classic step stapedotomy in 2 patients, a partial reverse classic step stapedotomy in 11 patients, and a hemi-stapedectomy in two patients.
Three of 24 patients (12.5%) treated with classic stapedotomy, 1 patient with partial reverse classic step stapedotomy, and 1 patient with hemi-stapedectomy were formally admitted to the hospital after surgery (length of stay, 23 h). The indications were vertigo (two patients) and asthenia (one patient). These patients were treated under general anesthesia. Two of these patients resided more than 250 km away from the hospital.
在我们看来，镫骨手术中镫骨切开术是首选技术。该技术的精确性使临床医生能够在局部麻醉下于日间手术中实施该手术操作。
目前大力强调增加择期日间手术病例的数量，特别是从患者的最大利益出发，因为这会降低手术延迟取消和医院获得性发病率的可能性。开展了一项前瞻性研究，以确定耳硬化症的镫骨手术是否能在门诊环境中安全进行。
我们展示了一系列在日间手术基础上为耳硬化症实施的镫骨手术病例。我们对9例患者进行了经典镫骨切开术，对2例患者进行了反向经典阶梯式镫骨切开术，对11例患者进行了部分反向经典阶梯式镫骨切开术，对2例患者进行了半镫骨切除术。
接受经典镫骨切开术治疗的24例患者中有3例（12.5%）、接受部分反向经典阶梯式镫骨切开术的1例患者以及接受半镫骨切除术的1例患者术后被正式收住入院（住院时间为23小时）。原因是眩晕（2例患者）和乏力（1例患者）。这些患者接受了全身麻醉。其中2例患者居住在距离医院250公里以上的地方。
