从砧骨搭桥术到镫骨切除术：技术改进与结果

From incus bypass to malleostapedotomy: technical improvements and results.

作者信息

Rambousek A, Schlegel C H, Linder T E

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital Luzern, Lucerne, Switzerland.

出版信息

J Laryngol Otol. 2012 Oct;126(10):995-1002. doi: 10.1017/S0022215112002034.

DOI:10.1017/S0022215112002034

PMID:22992269

Abstract

OBJECTIVE

To assess results of malleostapedotomy using a Fisch Storz titanium piston with at least 10 months' follow up.

METHODS

Using a prospective database, the indications, surgical technique, and pre- and post-operative audiometric data for 60 patients undergoing malleostapedotomy between 2002 and 2010 were evaluated. Diagnoses and primary and revision surgeries were compared with reference to the literature.

RESULTS

Sixty endaural malleostapedotomies were performed, 28 as a primary intervention and 32 as revision surgery. In 68 per cent, the underlying pathology was otosclerosis. The most common reason for revision surgery (i.e. in 59 per cent) was prosthesis dysfunction. Overall, the mean air-bone gap (0.5-3 kHz) for the primary intervention and revision surgery groups was 9.4 and 11.3 dB, respectively; an air-bone gap of less than 20 dB was obtained in 100 and 81 per cent of patients, respectively. There was no significant audiological difference between the primary and revision surgeries groups, and no deafness.

CONCLUSION

Malleostapedotomy shows comparable results to standard incus-stapedotomy and may be preferable in the presented situations.

摘要

目的

评估使用菲施·斯托兹钛制人工镫骨进行镫骨足板开窗术并至少随访10个月的结果。

方法

利用前瞻性数据库，对2002年至2010年间接受镫骨足板开窗术的60例患者的手术指征、手术技术以及术前和术后听力测定数据进行评估。将诊断结果以及初次手术和翻修手术情况与文献进行比较。

结果

共进行了60例耳内镫骨足板开窗术，其中28例为初次手术，32例为翻修手术。68%的患者潜在病理为耳硬化症。翻修手术最常见的原因（即59%）是人工镫骨功能障碍。总体而言，初次手术组和翻修手术组的平均气骨导间距（0.5 - 3千赫兹）分别为9.4分贝和11.3分贝；分别有100%和81%的患者气骨导间距小于20分贝。初次手术组和翻修手术组之间在听力学方面无显著差异，且无耳聋情况。