Sakalli Erdal, Celikyurt Cengiz, Guler Burak, Biskin Sultan, Tansuker Hasan Deniz, Erdurak Selcuk Cem
Department of Otorhinolaryngology, Safa Private Hospital, Fevzi cakmak mah. Sisecam bloklari. Emek apt. D:8 Bagcilar, Istanbul, Turkey.
Department of Otorhinolaryngology, Bulent Ecevit University Medical Faculty, Zonguldak, Turkey.
Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3271-5. doi: 10.1007/s00405-014-3414-7. Epub 2014 Dec 4.
We aimed to investigate the effect of stapes fixation on hearing results in patients who underwent mobilization surgery due to tympanosclerosis (TS). Seventy-nine patients were retrospectively analyzed and divided into two groups. Forty-four (55.7%) patients with mobile stapes were classified as group 1, and 35 (44.3%) patients with fixed stapes were classified as group 2. Improvement of the air-bone gap (ABG) to become less than 20 dB and the pure-tone average (PTA) by at least 10 dB postoperatively were accepted as success criteria. The PTA and ABG levels were significantly improved in both groups. The pre- and post-operative PTAs were 46.57 ± 15.55 and 25.84 ± 15.47 dB, respectively, in group 1 (p = 0.001). The pre- and post-operative PTAs were 55.64 ± 12.69 and 36.20 ± 14.47 dB, respectively, in group 2 (p = 0.001). The pre- and post-operative ABG levels were 35.36 ± 10.53 and 16.91 ± 8.54 dB, respectively, in group 1 (p = 0.001). The pre- and post-operative ABG levels were 41.68 ± 8.78 and 22.20 ± 10.03 dB, respectively, in group 2 (p = 0.001). A gain ≥10-dB in the PTA in groups 1 and 2 was found in 34 (77.2 %) and 23 (65.7%) patients, respectively, and the difference between the groups was not significant (p = 0.684). The post-operative AGB in groups 1 and 2 was less than 20 dB in 32 (72.7%) and 21 (60%) patients, respectively, and the difference between the groups was not significant (p = 0.733). No significant negative effect of stapes fixation on post-operative hearing results in TS was detected. Successful results can be obtained with a mobilization procedure, even if the stapes is fixed.
我们旨在研究镫骨固定对因鼓室硬化症(TS)接受镫骨活动手术患者听力结果的影响。对79例患者进行回顾性分析并分为两组。44例(55.7%)镫骨可活动的患者被归为第1组,35例(44.3%)镫骨固定的患者被归为第2组。术后气骨导间距(ABG)改善至小于20 dB且纯音平均听阈(PTA)至少提高10 dB被视为成功标准。两组的PTA和ABG水平均有显著改善。第1组术前和术后的PTA分别为46.57±15.55 dB和25.84±15.47 dB(p = 0.001)。第2组术前和术后的PTA分别为55.64±12.69 dB和36.20±14.47 dB(p = 0.001)。第1组术前和术后的ABG水平分别为35.36±10.53 dB和16.91±8.54 dB(p = 0.001)。第2组术前和术后的ABG水平分别为41.68±8.78 dB和22.20±10.03 dB(p = 0.001)。第1组和第2组分别有34例(77.2%)和23例(65.7%)患者的PTA增益≥10 dB,两组之间差异无统计学意义(p = 0.684)。第1组和第2组分别有32例(72.7%)和21例(60%)患者术后AGB小于20 dB,两组之间差异无统计学意义(p = 0.733)。未检测到镫骨固定对TS患者术后听力结果有显著负面影响。即使镫骨固定,通过镫骨活动手术也可获得成功结果。