Department of Otolaryngology, Head and Neck Surgery, Jagiellonian University, Cracow, Poland.
Department of Otolaryngology, Head and Neck Surgery, Jagiellonian University, Cracow, Poland.
Adv Med Sci. 2014 Mar;59(1):44-6. doi: 10.1016/j.advms.2013.07.004. Epub 2014 Mar 15.
The objective of this study is to evaluate the impact of changes to the mucous in the middle ear on the outcome of the reconstruction of the ossicular chain exemplified by a type 2 tympanoplasty.
MATERIAL/METHODS: A prospective analysis was carried out with regard to patients operated on at the Otolaryngology Department at Collegium Medicum, Jagiellonian University, between 2007 and 2011 due to conditions of the middle ear. The patients who had undergone surgical treatment for the first time because of chronic otitis media were taken into account. The operations involving a type 2 tympanoplasty were earmarked for further analysis. The effectiveness of treatment was measured by the change of the Air-Bone Gap (AGP).
The analysis covered 47 patients, whose own modeled incuses were placed on normal stapes. The patients were divided into two groups (with and without cholesteatoma). A statistically significant hearing improvement was observed in the patients with cholesteatoma. In the group without cholesteatoma and with a prevalence of granulomatous lesions, no statistically significant hearing improvement was observed 6 and 12 months following the ear surgery.
In the patients with cholesteatoma and a minor damage to the ossicular chain, a significant hearing improvement is observed after ossiculoplasty. An occurrence of granulomatous lesions is an unfavorable predictor. The Air-Bone Gap measured before the surgery often does not the actual advancement of the pathological process, and hearing improvement after the surgery cannot be prognosticated on the basis of that amount alone.
本研究旨在评估中耳黏膜变化对鼓室成形术（例如 2 型鼓室成形术）中耳骨链重建结果的影响。
材料/方法：对 2007 年至 2011 年间在雅盖隆大学医学院耳鼻喉科因中耳状况接受手术的患者进行了前瞻性分析。考虑了首次因慢性中耳炎接受手术治疗的患者。专门对涉及 2 型鼓室成形术的手术进行了进一步分析。通过气骨导差（AGP）的变化来衡量治疗效果。
该分析涵盖了 47 名患者，他们自身的模型砧骨被放置在正常的镫骨上。患者被分为两组（有无胆脂瘤）。在有胆脂瘤的患者中观察到听力显著改善。在无胆脂瘤且以肉芽病变为主的组中，在耳部手术后 6 个月和 12 个月时未观察到统计学上显著的听力改善。
在有胆脂瘤且中耳骨链轻度受损的患者中，鼓室成形术后听力显著改善。发生肉芽病变是不利的预测因素。术前测量的气骨导差通常不能反映实际的病理过程，且不能仅根据该值来预测术后听力改善。
