Amith Naragund, Rs Mudhol
Department of Otorhinolaryngology,Jawaharlal Nehru Medical College,Belagavi,India.
J Laryngol Otol. 2017 May;131(5):391-398. doi: 10.1017/S0022215117000251. Epub 2017 Feb 21.
This study aimed to compare the functional and anatomical outcomes of ossiculoplasty using an autograft incus or a titanium partial ossicular replacement prosthesis for reconstructing Austin type A ossicular defects.
Patients with Austin A ossicular defects were randomly divided into two groups: one group underwent ossiculoplasty with an autologous incus (the autologous incus group) and the other underwent ossiculoplasty with a titanium partial ossicular replacement prosthesis (the titanium prosthesis group). Otoscopic examination and audiological assessment was done pre-operatively and at 3, 6 and 12 months post-operatively.
A post-operative average air-bone gap closure of less than 20 dB was seen in 13 patients (65 per cent) in the autologous incus group and 7 (35 per cent) in the titanium prosthesis group. There were fewer post-operative complications in the autologous incus group (20 per cent) than in the titanium prosthesis group (45 per cent).
Hearing outcomes and graft take up after ossiculoplasty were significantly better when an autologous incus rather than a titanium partial ossicular replacement prosthesis was used to reconstruct Austin type A ossicular defects. The major disadvantages of the titanium prosthesis were unpredictable results and more post-operative complications.
本研究旨在比较使用自体砧骨或钛质部分听骨置换假体进行听骨链成形术重建奥斯汀A型听骨链缺损的功能和解剖学结果。
患有奥斯汀A型听骨链缺损的患者被随机分为两组：一组接受自体砧骨听骨链成形术（自体砧骨组），另一组接受钛质部分听骨置换假体听骨链成形术（钛质假体组）。术前以及术后3个月、6个月和12个月进行耳镜检查和听力学评估。
自体砧骨组13例患者（65%）术后平均气骨导差闭合小于20dB，钛质假体组7例患者（35%）如此。自体砧骨组术后并发症（20%）少于钛质假体组（45%）。
使用自体砧骨而非钛质部分听骨置换假体重建奥斯汀A型听骨链缺损时，听骨链成形术后的听力结果和移植物接受情况明显更好。钛质假体的主要缺点是结果不可预测且术后并发症更多。
