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镫骨固定对通过活动术治疗的鼓室硬化症听力结果的影响。

The effect of stapes fixation on hearing results in tympanosclerosis treated by mobilization.

作者信息

Sakalli Erdal, Celikyurt Cengiz, Guler Burak, Biskin Sultan, Tansuker Hasan Deniz, Erdurak Selcuk Cem

机构信息

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.

出版信息

Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3271-5. doi: 10.1007/s00405-014-3414-7. Epub 2014 Dec 4.

Abstract

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.

摘要

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。

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