Willis R
Cabrini Medical Center, Malvern, Australia.
Otolaryngol Head Neck Surg. 1989 Mar;100(3):224-6. doi: 10.1177/019459988910000309.
Records of 300 consecutive patients who had only one ear operated on by stapedectomy and who received long-term followup were studied. These cases came from 3036 stapedectomy operations performed between January 1961 and April 1969. In general, the two ears behaved the same: if a "flat" sensorineural loss occurred in one ear, it was likely to develop in the other. Similarly, if one ear developed a high-tone loss, the other would do likewise. With the exception of acute fistula, there is no suggestion that the operation of stapedectomy predisposes an ear to late sensorineural problems. Patients with bone-conduction thresholds that are depressed at all frequencies when first examined should be advised that progressive sensorineural hearing loss may occur later in both ears. Accordingly, the benefit gained by stapedectomy may ultimately need to be supplemented by hearing aids. This study also revealed that a patient with clinical conductive otosclerosis in only one ear at first presentation had only a 50% chance of long-term benefit from stapedectomy.
对300例仅接受过一次镫骨切除术且接受长期随访的连续患者的记录进行了研究。这些病例来自1961年1月至1969年4月期间进行的3036例镫骨切除术。一般来说,双耳表现相同:如果一只耳朵出现“平坦型”感音神经性听力损失,另一只耳朵也可能出现。同样,如果一只耳朵出现高频听力损失,另一只耳朵也会如此。除急性瘘管外,没有迹象表明镫骨切除术会使耳朵易患晚期感音神经性问题。首次检查时所有频率骨导阈值均降低的患者应被告知,双耳以后可能会出现进行性感音神经性听力损失。因此,镫骨切除术所带来的益处最终可能需要通过助听器来补充。这项研究还表明,首次就诊时仅一只耳朵患有临床传导性耳硬化症的患者,从镫骨切除术中获得长期益处的几率仅为50%。