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镫骨足板固定病例中三明治软骨瓣技术的长期随访研究

Long-term Follow-up Study of the Sandwich Cartilage Shoe Technique in Cases of Insecure Stapes Footplate.

作者信息

Lüers Jan Christoffer, Schwarz David, Anagiotos Andreas, Gostian Antoniu-Oreste, Beutner Dirk, Hüttenbrink Karl Bernd

机构信息

University of Cologne, Medical Faculty, Department of Otorhinolaryngology, Head and Neck Surgery, Cologne, Germany.

出版信息

Otol Neurotol. 2016 Aug;37(7):e197-202. doi: 10.1097/MAO.0000000000001093.

Abstract

OBJECTIVE

Analysis of the audiometric results after repair of a defective footplate with the sandwich cartilage shoe technique in a follow-up study.

STUDY DESIGN

Retrospective analysis of audiometric data.

SETTING

Hospital.

PATIENTS

The cohort consisted of 12 patients, who underwent ossicular reconstruction after sandwich cartilage shoe technique in a case of insecure stapes footplate. The mean age was 42.7 years with an equal sex distribution. In every patient, cholesteatoma was the reason for surgery with 75% being revision cases.

INTERVENTION

Sandwich cartilage shoe technique in case of insecure stapes footplate at the department of otorhinolaryngology, head and neck surgery at the University of Cologne over an 8-year period (2007-2015).

MAIN OUTCOME MEASURE

The use of the "sandwich cartilage shoe technique" in case of a broken or unstable footplate allows a safe occlusion of the open vestibule.

RESULTS

The statistical analysis revealed a significant improvement of the pure-tone average (p = 0.011) and air-bone gap (ABG) (p = 0.016) after total ossicular replacement prosthesis (TORP) implantation. The hearing was stable at 9 months of follow up.

CONCLUSION

The sandwich cartilage shoe technique offers a safe and effective option as a two-stage procedure in treating patients with fractures of the stapes footplate in case of chronic otitis media. In view of the possible risk of deafness going along with a destruction of an inner ear window, our results can be considered substantial as all our patients will at least be able to regain "social hearing" as they all either achieved a hearing threshold is less than 30 dB or can be sufficiently supplied with a conventional hearing aid.

摘要

目的

在一项随访研究中,分析采用三明治软骨片技术修复镫骨足板缺损后的听力测试结果。

研究设计

对听力测试数据进行回顾性分析。

研究地点

医院。

患者

该队列由12名患者组成,他们因镫骨足板固定不牢接受了三明治软骨片技术的听骨链重建手术。平均年龄为42.7岁,男女比例均等。每位患者均因胆脂瘤接受手术,其中75%为翻修病例。

干预措施

在科隆大学耳鼻咽喉头颈外科,于8年期间(2007 - 2015年),针对镫骨足板固定不牢的情况采用三明治软骨片技术。

主要观察指标

在镫骨足板破损或不稳定的情况下,使用“三明治软骨片技术”可安全封闭开放的前庭。

结果

统计分析显示,全听骨链置换假体(TORP)植入后,纯音平均听阈(p = 0.011)和气骨导差(ABG)(p = 0.016)有显著改善。随访9个月时听力稳定。

结论

三明治软骨片技术作为一种两阶段手术,为治疗慢性中耳炎导致的镫骨足板骨折患者提供了一种安全有效的选择。鉴于内耳窗破坏可能伴随耳聋风险,我们的结果意义重大,因为所有患者至少能够恢复“社交听力”,要么听力阈值低于30dB,要么可通过传统助听器获得足够听力补偿。

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