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镫骨前庭固定术与全听骨链重建赝复物治疗镫骨足板活动的慢性中耳炎患者听力结果的比较

Comparison of hearing results of malleovestibulopexy and total ossicular replacement prosthesis for chronic otitis media patients with a mobile stapes footplate.

作者信息

Chen Zhengnong, Sun Xiaoqiang, Zhou Huiqun, Shi Haibo, Wu Yaqin, Yin Shankai

机构信息

Department of Otolaryngology, Otolaryngology Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

出版信息

Ann Otol Rhinol Laryngol. 2014 May;123(5):343-6. doi: 10.1177/0003489414526366. Epub 2014 Mar 26.

Abstract

OBJECTIVE

This study aimed to assess differences in hearing outcomes using the malleostapedotomy or malleovestibulopexy (MVP) and total ossicular replacement prosthesis (TORP) techniques in chronic otitis media patients with a mobile stapes footplate.

STUDY DESIGN

Case series with planned data collection.

SETTING

A university medical center.

SUBJECTS AND METHODS

In total, 27 patients with chronic otitis media at the Sixth Hospital affiliated with Shanghai Jiao Tong University, between January and October 2010, were included. All patients had destruction of incus and stapes superstructures and a mobile stapes footplate. In all patients, surgery was performed under general anesthesia by a retroauricular approach. After the lesions were removed completely, ossicular reconstruction was performed using 1 of the techniques. In all patients, pure-tone audiograms were assessed before and 12 months after surgery.

RESULTS

Thirteen patients underwent MVP surgery, whereas the other 14 cases received traditional TORP surgery. All patients showed improvements in functional hearing after surgery. Although the numbers of ears that had closure of the air-bone gap within 20 dB in the MVP group were not statistically significantly higher than those in the TORP group (Fisher's exact test, P > .05), the average postoperative gain of the MVP group was significantly higher than that of the TORP group (t test, P < .05).

CONCLUSION

Functional hearing in chronic otitis media patients with a mobile stapes footplate was better in those who underwent MVP surgery than in those who underwent TORP surgery.

摘要

目的

本研究旨在评估在镫骨足板活动的慢性中耳炎患者中,使用镫骨切除术或镫骨前庭固定术(MVP)及全听骨链重建假体(TORP)技术的听力结果差异。

研究设计

有计划数据收集的病例系列研究。

研究地点

一所大学医学中心。

研究对象与方法

纳入了2010年1月至10月期间在上海交通大学附属第六人民医院的27例慢性中耳炎患者。所有患者均有砧骨和镫骨上部结构破坏且镫骨足板活动。所有患者均在全身麻醉下经耳后入路进行手术。在彻底清除病变后,使用其中一种技术进行听骨链重建。所有患者在手术前及术后12个月均进行纯音听力图评估。

结果

13例患者接受了MVP手术,另外14例接受了传统的TORP手术。所有患者术后功能性听力均有改善。虽然MVP组气骨导差缩小至20dB以内的耳数在统计学上并不显著高于TORP组(Fisher精确检验,P>.05),但MVP组术后平均增益显著高于TORP组(t检验,P<.05)。

结论

镫骨足板活动的慢性中耳炎患者,接受MVP手术者的功能性听力比接受TORP手术者更好。

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