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耳硬化症患者部分镫骨切除术延迟:对术后长期听力结果的影响。

Delaying partial stapedectomy for otosclerosis: effects on long-term hearing outcomes following surgery.

作者信息

Maniakas Anastasios, Nehme Jade, Dufour Jean-Jacques, Saliba Issam

机构信息

Division of Otolaryngology Head and Neck Surgery, Montreal University Hospital Center (CHUM), Hôpital Notre Dame, 1560 Sherbrooke Street East, Montreal, QC, H2L 4M1, Canada.

出版信息

Eur Arch Otorhinolaryngol. 2015 Jul;272(7):1605-11. doi: 10.1007/s00405-014-2958-x. Epub 2014 Mar 8.

DOI:10.1007/s00405-014-2958-x
PMID:24609646
Abstract

The purpose of this study is to evaluate hearing outcomes following partial stapedectomy according to age at the time of surgery and evaluate functional hearing at ≥ 10 years' follow-up, and to assess the effect of delay in surgery on overall functional hearing outcomes. Data were collected from patients operated upon for otosclerosis by a single surgeon from 1990 to 1999. Pure-tone air (PTA), pure-tone bone (PTB), air-bone gap (ABG), air-conduction at 8 kHz (AC 8), bone-conduction at 4 kHz (BC4) and speech discrimination score (SDS) were compared between patients <45 and ≥ 45 years old, as well as correlated with overall age preoperatively, short term (4 months) and long term (>10 years), postoperatively. Forty-five patients were included with a mean follow-up of 12.6 years. Mean preoperative ABG and AC 8 values were significantly different between the two age groups (p = 0.002; p = 0.010, respectively). No values remained significantly different between the two age groups at the long-term follow-up. ABG values correlated with age preoperatively (p = 0.001), although no correlation was seen short- and long-term postoperatively (p = 0.980; p = 0.495, respectively). Mean PTA, PTB, and ABG values showed a significant improvement in both groups preoperatively to short-term postoperatively (p < 0.001). Although mean PTA values decreased significantly from short- to long-term follow-ups in both groups (p = 0.033; p = 0.020), the improvement from the preoperative state remained significant (p < 0.001). Regardless of age at the time of surgery, long-term hearing levels will evolve similarly in patients <45 and ≥ 45 years old. Furthermore, no difference will be seen in hearing measurements between the two age groups at ≥ 10 years postoperatively. Delaying a surgery would thus not affect overall long-term hearing outcomes.

摘要

本研究的目的是根据手术时的年龄评估部分镫骨切除术的听力结果,并在随访≥10年时评估功能性听力,同时评估手术延迟对整体功能性听力结果的影响。数据收集自1990年至1999年由单一外科医生进行耳硬化症手术的患者。比较了<45岁和≥45岁患者的纯音气导(PTA)、纯音骨导(PTB)、气骨导间距(ABG)、8kHz气导(AC 8)、4kHz骨导(BC4)和言语辨别得分(SDS),并将其与术前、术后短期(4个月)和长期(>10年)的总体年龄进行相关性分析。纳入45例患者,平均随访12.6年。两个年龄组术前的平均ABG和AC 8值存在显著差异(分别为p = 0.002;p = 0.010)。在长期随访中,两个年龄组之间没有值仍存在显著差异。ABG值术前与年龄相关(p = 0.001),尽管术后短期和长期均未发现相关性(分别为p = 0.980;p = 0.495)。两组术前至术后短期的平均PTA、PTB和ABG值均有显著改善(p < 0.001)。尽管两组从短期随访到长期随访时平均PTA值均显著下降(分别为p = 0.033;p = 0.020),但与术前状态相比仍有显著改善(p < 0.001)。无论手术时的年龄如何,<45岁和≥45岁患者的长期听力水平变化相似。此外,术后≥10年时,两个年龄组的听力测量结果没有差异。因此,延迟手术不会影响整体长期听力结果。

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本文引用的文献

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Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis: a prospective study with the otology-neurotology database.3050例原发性耳硬化镫骨切除术的手术发现及长期听力结果:一项基于耳科学-神经耳科学数据库的前瞻性研究
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Air and bone conduction change after stapedotomy and partial stapedectomy for otosclerosis.耳硬化症行镫骨切除术和部分镫骨切除术后气导和骨导的变化。
Otolaryngol Head Neck Surg. 2005 Jul;133(1):116-20. doi: 10.1016/j.otohns.2005.03.011.
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