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通气导管作为慢性中耳炎患者鼓室成形术中部分听骨置换假体（PORP）的效用。

Usefulness of a ventilation tube as a partial ossicular replacement prosthesis (PORP) in ossiculoplasty in patients with chronic otitis media.

作者信息

Wiatr Maciej, Składzień Jacek, Tomik Jerzy, Stręk Paweł

机构信息

Department of Otolaryngology, Head and Neck Surgery, Jagiellonian University, Cracow, Poland.

出版信息

Med Sci Monit. 2014 Jun 13;20:974-9. doi: 10.12659/MSM.890447.

DOI:10.12659/MSM.890447
PMID:24935173
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4067421/
Abstract

BACKGROUND

The principal objective of ossiculoplasty is to reconstruct the sound-conducting system in the ear to the best possible degree after the elimination of pathological lesions from the middle ear. The ossicular chain is reconstructed with the use of the patient's own properly modelled ossicles and synthetic prostheses. The objective of the study was to assess the degree of hearing improvement after tympanoplasty in patients for whom a ventilation tube was used as a partial ossicular replacement prosthesis (PORP).

MATERIAL AND METHODS

Between 2009 and 2012, 387 patients underwent ear surgery at the Otolaryngological Teaching Hospital of the Collegium Medicum at the Jagiellonian University of Cracow. We focussed on the patients in whom a vibrating element in the form of a properly modelled anvil or a ventilation tube was attached to the preserved and normally mobile stapes.

RESULTS

A significant hearing improvement was observed in patients with type 2 tympanoplasty in the course of chronic cholesteatoma otitis media and in patients with simple chronic inflammatory process in whom a ventilation tube was used as a PORP in the reconstruction. Granulation tissue was determined to be an unfavorable factor in the prognosis of hearing improvement following tympanoplasty.

CONCLUSIONS

Significant hearing improvement was observed after type 2 tympanoplasty in patients with cholesteatoma whose ossicular chain was not appreciably damaged. A ventilation tube used as a PORP is an effective alternative in the reconstruction of the ossicular chain.

摘要

背景

鼓室成形术的主要目标是在清除中耳病理病变后，尽可能地重建耳内的声音传导系统。使用患者自身经过适当塑形的听小骨和合成假体来重建听骨链。本研究的目的是评估在使用通气管作为部分听骨置换假体（PORP）的患者中，鼓室成形术后听力改善的程度。

材料与方法

2009年至2012年期间，387例患者在克拉科夫雅盖隆大学医学院耳鼻喉科教学医院接受了耳部手术。我们重点关注那些将经过适当塑形的砧骨或通气管形式的振动元件附着于保留且活动正常的镫骨上的患者。

结果

在慢性胆脂瘤性中耳炎患者的2型鼓室成形术中，以及在将通气管用作重建中的PORP的单纯慢性炎症过程患者中，观察到听力有显著改善。肉芽组织被确定为鼓室成形术后听力改善预后的不利因素。

结论

在听骨链未明显受损的胆脂瘤患者中，2型鼓室成形术后观察到听力有显著改善。用作PORP的通气管是听骨链重建的有效替代物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/a4116d2e3697/medscimonit-20-974-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/6c8dacfb1158/medscimonit-20-974-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/34dcdaa8622e/medscimonit-20-974-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/3d4f3527c367/medscimonit-20-974-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/a4116d2e3697/medscimonit-20-974-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/6c8dacfb1158/medscimonit-20-974-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/34dcdaa8622e/medscimonit-20-974-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/3d4f3527c367/medscimonit-20-974-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f8a/4067421/a4116d2e3697/medscimonit-20-974-g004.jpg

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慢性中耳炎手术患者气骨导差及骨导变化的决定因素
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