Department of Anatomy and Neurobiology, Dalhousie University, Halifax, NS.
J Otolaryngol Head Neck Surg. 2012 Apr;41(2):84-93.
In the absence of the incus, many surgeons believe that reconstruction from the tympanic membrane to the stapes head is more effective than reconstruction to the stapes footplate. This has rarely been tested empirically. Published better clinical results with reconstruction to the stapes head might simply reflect less underlying disease in ears with an intact stapes superstructure.
To compare vibration transmission of these two forms of prosthetic reconstruction.
A fresh human cadaveric temporal bone model was used. Round window vibrations in response to sound in the ear canal were measured with a laser Doppler vibrometer. After incus removal, the discontinuity was repaired using a titanium prosthesis. Reconstruction from the tympanic membrane to the stapes head was compared to reconstruction to the stapes footplate.
Reconstruction of both types decreased round window vibrations by 10 to 15 dB between 500 and 3000 Hz compared to the intact middle ear. Reconstruction to the stapes head performed 5 to 10 dB better at lower frequencies (500-2000 Hz), but this was only statistically significant at 1 and 2 kHz.
There is only a 5 to 10 dB mechanical advantage gained by reconstruction from the tympanic membrane to the stapes head compared to reconstruction to the footplate for frequencies between 1 and 2 kHz.
在没有砧骨的情况下，许多外科医生认为，从鼓膜到镫骨头部的重建比重建到镫骨足板更有效。这很少有经验性的验证。重建到镫骨头部的发表结果更好，可能仅仅反映了完整镫骨上部的耳朵中潜在疾病较少。
比较这两种形式的假体重建的振动传递。
使用新鲜的人尸体颞骨模型。通过激光多普勒测振仪测量响应于耳道声音的圆窗振动。去除砧骨后，使用钛假体修复不连续性。比较鼓膜至镫骨头部的重建与重建至镫骨足板。
与完整的中耳相比，两种类型的重建都使 500 至 3000Hz 之间的圆窗振动降低了 10 至 15dB。重建到镫骨头部在较低频率（500-2000Hz）下的效果好 5 至 10dB，但仅在 1 和 2kHz 时具有统计学意义。
对于 1 至 2kHz 之间的频率，从鼓膜到镫骨头部的重建与重建到足板相比，仅具有 5 至 10dB 的机械优势。
