CHEN Bing, TAO Duo-duo
Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Apr;47(4):270-3.
To explore the efficacy of total and partial ossicular chain reconstruction using titanium implants.
Total of 106 patients (107 ears) underwent ossiculoplasty using titanium from June 2008 to January 2011. Eighty-six ears had partial ossicular replacement prosthesis (PORP) and 21 ears had total ossicular replacement prosthesis (TORP). Patient data were collected retrospectively from the database of surgical cases. Patients were assessed during 6 to 30 months postoperatively to establish middle- and long-term hearing results. Average postoperative air-conduction gain and air-bone gap (ABG) were measured at four frequencies: 0.5, 1, 2, and 4 kHz.
Postoperative air-bone gap of 20 dB or less than 20 dB was obtained in 83.7% of PORP cases versus 71.4% of TORP cases. All the cases obtained significant postoperative air-conduction gains. The change in air-bone gap (defined as the difference between the means of preoperative and postoperative ABG) was 12.5 dB for PORP patients and 12.9 dB for the TORP patients. There was no statistically significant difference between the TORP and PORP groups. Prosthesis exclusion was observed in one case (0.9%).
Prostheses using titanium type could give good functional results and stability with low exclusion rate to patients presenting chronic otitis media.
探讨使用钛植入物进行全听骨链重建和部分听骨链重建的疗效。
2008年6月至2011年1月期间，共有106例患者（107耳）接受了钛质听骨成形术。86耳使用部分听骨赝复物（PORP），21耳使用全听骨赝复物（TORP）。患者数据从手术病例数据库中回顾性收集。在术后6至30个月对患者进行评估，以确定中长期听力结果。在0.5、1、2和4 kHz四个频率下测量术后平均气导增益和气骨导间距（ABG）。
PORP病例中83.7%的患者术后气骨导间距达到20 dB或小于20 dB，TORP病例中这一比例为71.4%。所有病例术后气导均有显著增益。PORP患者气骨导间距的变化（定义为术前和术后ABG均值之差）为12.5 dB，TORP患者为12.9 dB。TORP组和PORP组之间无统计学显著差异。观察到1例（0.9%）假体排斥反应。
对于慢性中耳炎患者，使用钛质假体可获得良好的功能结果和稳定性，且排斥率低。
