Singh P P, Goyal Arun
Department of Otorhinolaryngology, University College of Medical Sciences & G T B Hospital, Delhi, 110095 India.
Department of Otorhinolaryngology, University College of Medical Sciences & G T B Hospital, Delhi, 110095 India ; D-278 Second Floor, Sarvodaya Enclave, New Delhi, 110017 India.
Indian J Otolaryngol Head Neck Surg. 2013 Jul;65(3):280-2. doi: 10.1007/s12070-011-0459-4. Epub 2012 Jan 6.
The crimping of stapes prosthesis to the long process of incus has always been the bugbear of an otologist. Malcrimping on one hand can lead to necrosis of the long process on the other it can lead to a residual air-bone gap or a postoperative reappearance of the conductive hearing loss. To solve these problems different types of stapes prostheses having different techniques to achieve a secure attachment to incus have been devised. Retrospective analysis of patient data. Tertiary care hospital. Case records of 20 patients of otosclerosis who had undergone stapedotomy using titanium soft clip stapes piston (Kurz, Germany) were retrospectively analysed. This new type of stapes piston is a modification of the earlier àWengen clip piston (Kurz, Germany) which was designed to avoid the crimping onto the incus in stapedotomy. Hearing results were analyzed using American Academy of Otolaryngology-Head and Neck Surgery guidelines including 4 frequency pure tone average. The mean postoperative air-bone gap was with in 10 dB in 8 (40% of cases), up to 15 dB in another 8 (40%) cases and in rest 4 (20%) was with in 20 dB. No adverse reactions occurred during follow-up. The use of the titanium soft clip stapes piston gives good results in cases of stapedotomy for otosclerosis. The soft clip design is a new development in the evolution of stapes piston prostheses. Surgical introduction, placement, and fixation are easier than the earlier àWengen design of clip piston.
将镫骨假体固定于砧骨长突一直是耳科医生面临的难题。一方面,固定不当可能导致砧骨长突坏死,另一方面,可能导致残余气骨间隙或术后传导性听力损失再次出现。为了解决这些问题,人们设计了不同类型的镫骨假体,采用不同技术以实现与砧骨的牢固连接。对患者数据进行回顾性分析。三级护理医院。对20例耳硬化症患者的病例记录进行回顾性分析,这些患者接受了使用钛质软夹镫骨活塞(德国库尔兹公司)的镫骨切除术。这种新型镫骨活塞是对早期温根夹活塞(德国库尔兹公司)的改良,后者旨在避免在镫骨切除术中将其固定于砧骨。根据美国耳鼻咽喉-头颈外科学会指南分析听力结果,包括4频率纯音平均听阈。术后平均气骨间隙在8例(40%)中小于10dB,在另外8例(40%)中高达15dB,其余4例(20%)中小于20dB。随访期间未发生不良反应。在耳硬化症镫骨切除术病例中,使用钛质软夹镫骨活塞取得了良好效果。软夹设计是镫骨活塞假体发展中的一项新进展。手术植入、放置和固定比早期的温根夹活塞设计更容易。