Hess-Erga Jeanette, Engelen Bart Lambertus Henricus Jozef, Vassbotn Flemming Slinning
Department of Otorhinolaryngology and Head and Neck Surgery, Haukeland University Hospital, 5021, Bergen, Norway.
Eur Arch Otorhinolaryngol. 2017 Apr;274(4):1859-1864. doi: 10.1007/s00405-016-4429-z. Epub 2016 Dec 20.
The most common technique in sound restoration of the middle ear is prosthetic surgery. Hypoventilation of the middle ear may cause adhesive otitis or atelectasis resulting in a higher risk of prosthetic extrusion rate and recurrence of the underlying cholesteatoma. We report long-term results using an island of tragal cartilage as an autologous PORP in selected patients with poor middle ear ventilation. Retrospective chart reviews were performed for procedures involving 52 patients between year 2000 and 2009. All patients that underwent surgery using tragal cartilage interposed between the suprastructure of the stapes and the tympanic membrane were included in this study. Audiological parameters using four frequencies, 0.5, 1, 2 and 3 kHz, according to AAO-HNS guidelines, were assessed pre-and postoperatively. The hearing results on different PTA frequencies were also investigated. We report long-term follow-up of patients with hypoventilated middle ear with a success rate of 71% (ABG <20%). With regards to the ABG, the low frequency component (5 and 1 kHz) showed a significantly (p < 0.05) larger improvement of mean values after surgery as compared to the high-frequency component (2 and 3 kHz). Cartilage island PORP on stapes is a stable and efficient method for selected patients with chronic middle ear disease.
中耳声音恢复最常见的技术是修复手术。中耳通气不足可能导致粘连性中耳炎或肺不张，从而使修复体挤出率和潜在胆脂瘤复发的风险更高。我们报告了在中耳通气不良的选定患者中使用耳屏软骨岛作为自体部分听骨赝复物（PORP）的长期结果。对2000年至2009年间涉及52例患者的手术进行了回顾性病历审查。本研究纳入了所有在镫骨上部结构和鼓膜之间插入耳屏软骨进行手术的患者。根据美国耳鼻咽喉头颈外科学会（AAO-HNS）指南，在术前和术后评估了0.5、1、2和3kHz四个频率的听力学参数。还研究了不同纯音平均听阈（PTA）频率的听力结果。我们报告了中耳通气不良患者的长期随访情况，成功率为71%（气骨导差<20%）。关于气骨导差，低频成分（500和1kHz）术后平均值的改善明显（p<0.05）大于高频成分（2和3kHz）。镫骨上的软骨岛PORP对选定的慢性中耳疾病患者是一种稳定且有效的方法。
