Chavan Shrinivas Shripatrao, Jain Prateek V, Vedi Jeevan N, Rai Dharmendra Kumar, Kadri Himayat
Department of Otorhinolaryngology, Government Medical College, Aurangabad , India.
Iran J Otorhinolaryngol. 2014 Jul;26(76):143-50.
The use of ossicular graft material in ossicular chain reconstruction has significantly improved hearing results hearing after tympanoplasty and tympanomastoid surgery for chronic otitis media. Today, otologists have a wide array of tools from which to choose, but may find it difficult to know which middle ear implant works best.
A prospective study of 80 patients who underwent ossiculoplasty was performed in the ear, nose, and throat (ENT) department at a tertiary health care facility from 2011 to 2013. Patients with chronic suppurative otitis media with an air-bone gap (ABG) of >25 dB with ossicular involvement were included in the study. Total ossicular replacement prosthesis (TORP), partial ossicular replacement prosthesis (PORP), and refashioned incus were used. Success was defined as ABG <25 dB on postoperative Day 90.
The majority patients were of middle age with moderate conductive hearing loss. Incus was the most susceptible ossicle. Overall success rate in this study was 80.0% with an average change of 15.76 dB in ABG.
With continuing advances in our understanding of middle ear mechanics, the results of ossiculoplasty are improving and results can be very rewarding in experienced hands. Severity of preoperative ear discharge, preoperative mastoid cellularity, presence of disease, and surgical procedure proved to be significant prognostic factors. Autograft incus and PORP fared better when the malleus handle was present while TORP gave better results when the malleus handle was eroded.
在慢性中耳炎的鼓室成形术和鼓室乳突手术中，使用听骨移植材料显著改善了听力结果。如今，耳科医生有多种工具可供选择，但可能难以确定哪种中耳植入物效果最佳。
2011年至2013年，在一家三级医疗机构的耳鼻喉科对80例行听骨成形术的患者进行了一项前瞻性研究。纳入研究的患者为慢性化脓性中耳炎，气骨导差（ABG）>25dB且伴有听骨受累。使用了全听骨置换假体（TORP）、部分听骨置换假体（PORP）和重塑砧骨。成功定义为术后第90天ABG<25dB。
大多数患者为中年，伴有中度传导性听力损失。砧骨是最易受累的听骨。本研究的总体成功率为80.0%，ABG平均变化15.76dB。
随着我们对中耳力学认识的不断进步，听骨成形术的结果正在改善，在经验丰富的医生手中，结果可能非常令人满意。术前耳漏的严重程度、术前乳突气房情况、疾病的存在以及手术操作被证明是重要的预后因素。当锤骨柄存在时，自体砧骨和PORP效果更好，而当锤骨柄被侵蚀时，TORP效果更好。
