Thomeer Henricus G X M, Kunst Henricus P M, Cremers Cor W R J
Department of Otorhinolaryngology, Donders Institute for Neuroscience, Nijmegen, the Netherlands.
Ann Otol Rhinol Laryngol. 2012 Apr;121(4):275-81. doi: 10.1177/000348941212100414.
We describe the audiometric results following surgery in a consecutive series of patients with a congenital ossicular middle ear disorder that was associated with a mobile stapes footplate.
We performed a retrospective analysis of patient charts from a tertiary referral center. A total of 23 patients (23 ears) underwent exploratory tympanotomy and ossicular reconstruction between 1986 and 2001. The main outcome measure was the audiometric results.
Overall, we observed a mean gain in air conduction pure tone average of 17 dB (from 47 dB to 30 dB), a sensorineural deterioration of 3 dB, and a mean postoperative air-bone gap of 19 dB (mean preoperative air-bone gap of 38 dB). The air-bone gap closure was 20 dB or less in 15 of the 23 cases (65%), in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the syndromic group, the mean gain in air conduction was only 13 dB, which was worse than that observed for the nonsyndromic ears.
Surgery for congenital ossicular chain anomalies with a concomitant mobile stapes footplate provides positive audiometric outcomes. Most ears had some sensorineural impairment (10 to 20 dB), which influenced the final hearing level attained after surgery. Preoperative assessment is mandatory to search for syndromal diagnoses, which might be important for patient counseling and prognosis.
我们描述了一系列连续性先天性听骨链中耳疾病且镫骨足板活动的患者术后的听力测试结果。
我们对一家三级转诊中心的患者病历进行了回顾性分析。1986年至2001年间，共有23例患者（23耳）接受了探查性鼓室切开术和听骨链重建术。主要观察指标为听力测试结果。
总体而言，我们观察到气导纯音平均增益为17dB（从47dB降至30dB），感音神经性听力下降3dB，术后平均气骨导间距为19dB（术前平均气骨导间距为38dB）。23例中有15例（65%）气骨导间距缩小至20dB或更小，这与文献中报道的少数结果一致。此外，听力测试结果保持稳定。在综合征组中，气导平均增益仅为13dB，比非综合征耳的情况更差。
伴有镫骨足板活动的先天性听骨链异常手术可带来良好的听力测试结果。大多数耳朵存在一定程度的感音神经性损害（10至20dB），这影响了术后最终达到的听力水平。术前评估必须寻找综合征诊断，这对患者咨询和预后可能很重要。
