Révész Péter, Szanyi István, Ráth Gábor, Bocskai Tímea, Lujber László, Piski Zalán, Karosi Tamás, Gerlinger Imre
Department of Otorhinolaryngology and Head and Neck Surgery, Clinical Center, Medical School, University of Pécs, Munkácsy M. utca 2, Pécs, 7621, Hungary.
Department of Paediatric Otorhinolaryngology, Clinical Center, University of Pécs, Pécs, Hungary.
Eur Arch Otorhinolaryngol. 2016 May;273(5):1131-6. doi: 10.1007/s00405-015-3662-1. Epub 2015 May 28.
The aim of this retrospective study was to compare the 3-month postoperative hearing results following laser stapedotomy with the use of NiTiBOND versus Nitinol prostheses (31 and 39 patients, respectively). The operations were performed between September 2012 and September 2014, and between March 2006 and December 2012 regarding NiTiBOND and Nitinol, respectively. Twenty of the consecutive 31 patients were female and 11 were male for NiTiBOND, while 11 were male and 28 were female for Nitinol. The mean age was 43.8 years (range 22-61) and 46.9 years (range 28-83) for NiTiBOND and Nitinol, respectively. No significant cochlear trauma was documented postoperatively. The mean air-bone gap (ABG) for the frequencies 0.5, 1, 2 and 3 kHz at the 3-month postoperative follow-up was 7.6 dB (SD 4.7), and 9.3 dB (SD 4.1) for NiTiBOND and Nitinol, respectively. The differences between the mean pre- (p = 0.179), and postoperative (p = 0.059) ABG of the two groups were not significant. ABG closure within 10 dB was achieved in 77.4 and 59 % for NiTiBOND and Nitinol, respectively, the difference was not significant (p = 0.10). Two cases of delayed facial paralysis occurred, 1 with Nitinol and 1 with the NiTiBOND. All patients attained an ABG <20 dB following surgery. Laser stapedotomy with the application of either heat-memory piston prosthesis allowed an easy and minimally invasive approach with excellent short-term hearing results when the NiTiBOND prosthesis was applied. Laser application allowed manipulation in a bloodless environment and avoided manual crimping of the incus.
这项回顾性研究的目的是比较分别使用镍钛键合（NiTiBOND）和镍钛诺假体（分别为31例和39例患者）进行激光镫骨切除术后3个月的听力结果。手术分别于2012年9月至2014年9月以及2006年3月至2012年12月进行，前者使用NiTiBOND，后者使用镍钛诺。在连续的31例使用NiTiBOND的患者中，20例为女性，11例为男性；而在使用镍钛诺的患者中，11例为男性，28例为女性。使用NiTiBOND和镍钛诺患者的平均年龄分别为43.8岁（范围22 - 61岁）和46.9岁（范围28 - 83岁）。术后未记录到明显的耳蜗损伤。术后3个月随访时，0.5、1、2和3 kHz频率的平均气骨导间距（ABG）在使用NiTiBOND时为7.6 dB（标准差4.7），在使用镍钛诺时为9.3 dB（标准差4.1）。两组术前（p = 0.179）和术后（p = 0.059）平均ABG的差异均无统计学意义。使用NiTiBOND和镍钛诺时，ABG在10 dB以内闭合的比例分别为77.4%和59%，差异无统计学意义（p = 0.10）。发生了2例迟发性面神经麻痹，1例使用镍钛诺，1例使用NiTiBOND。所有患者术后ABG均<20 dB。当应用NiTiBOND假体时，使用任何一种热记忆活塞假体进行激光镫骨切除术都能实现简便且微创的手术方式，并取得优异的短期听力结果。激光应用使得手术能在无血环境中操作，避免了砧骨的手工压接。
