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先天性外耳道狭窄行外耳道鼓室成形术后长期听力结果的有利预后因素。

Favorable prognostic factors for long-term postoperative hearing results after canal tympanoplasty for congenital aural stenosis.

作者信息

Sakamoto Takashi, Kikkawa Yayoi S, Kikuta Shu, Kinoshita Makoto, Ueha Rumi, Suzukawa Keigo, Kashio Akinori, Kakigi Akinobu, Ito Ken, Suzuki Mitsuya, Yamasoba Tatsuya

机构信息

*Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, Faculty of Medicine, University of Tokyo, Tokyo; †Department of Otolaryngology and Head and Neck Surgery, University of Teikyo, Tokyo; and ‡Department of Otolaryngology and Head and Neck Surgery, University of Toho, Sakura, Chiba, Japan.

出版信息

Otol Neurotol. 2014 Jul;35(6):966-71. doi: 10.1097/MAO.0000000000000335.

Abstract

OBJECTIVE

We aimed to determine favorable prognostic factors for long-term postoperative hearing results after canal tympanoplasty for congenital aural stenosis (CAS).

STUDY DESIGN

Retrospective case review.

SETTING

Tertiary referral center.

PATIENTS

Canal tympanoplasty for CAS was performed in 25 ears.

INTERVENTION

Primary repair of CAS.

MAIN OUTCOME MEASURES

The influences of the following factors on the success of surgery were assessed by univariate and multivariate logistic regression analyses: modified Jahrsdoerfer grading system total score; age at surgery; patterns of presentation (whether sporadic or syndromic); presence of external auditory canal (EAC) cholesteatoma; presence of ossicular fixation, including the malleus bar; presence of a partial atretic plate; exposure of the facial nerve at the tympanic portion; type of tympanoplasty; and each component of the modified Jahrsdoerfer grading system.

RESULTS

The univariate analysis revealed that the absence of EAC cholesteatoma (p = 0.029) and the presence of a partial atretic plate (p = 0.040) were significant predictive factors for favorable hearing prognosis, whereas the multivariate logistic regression analysis showed that an absence of EAC cholesteatoma was the most significant favorable predictive factor (p = 0.011), followed by anterolateral position of the malleus/incus complex with respect to the stapes as the second-most favorable factor (p = 0.021).

CONCLUSION

The absence of EAC cholesteatoma and anterolateral position of the malleus/incus complex with respect to the stapes are considered useful in predicting long-term favorable hearing results after canal tympanoplasty for CAS.

摘要

目的

我们旨在确定先天性外耳道狭窄(CAS)行外耳道鼓室成形术后长期听力结果的有利预后因素。

研究设计

回顾性病例分析。

研究地点

三级转诊中心。

患者

对25耳进行了CAS外耳道鼓室成形术。

干预措施

CAS的一期修复。

主要观察指标

通过单因素和多因素逻辑回归分析评估以下因素对手术成功的影响:改良Jahrsdoerfer分级系统总分;手术年龄;表现形式(散发性或综合征性);外耳道(EAC)胆脂瘤的存在;听骨固定的存在,包括锤骨杆;部分闭锁板的存在;面神经鼓室段暴露;鼓室成形术类型;以及改良Jahrsdoerfer分级系统的各个组成部分。

结果

单因素分析显示,不存在EAC胆脂瘤(p = 0.029)和存在部分闭锁板(p = 0.040)是听力预后良好的重要预测因素,而多因素逻辑回归分析表明,不存在EAC胆脂瘤是最重要的有利预测因素(p = 0.011),其次是锤骨/砧骨复合体相对于镫骨的前外侧位置,为第二有利因素(p = 0.021)。

结论

不存在EAC胆脂瘤以及锤骨/砧骨复合体相对于镫骨的前外侧位置被认为有助于预测CAS行外耳道鼓室成形术后的长期良好听力结果。

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