Yawn Robert J, Hunter Jacob B, O'Connell Brendan P, Wanna George B, Killeen Daniel E, Wick Cameron C, Isaacson Brandon, Rivas Alejandro
*Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee †Department of Otolaryngology-Head and Neck Surgery, UT Southwestern, Dallas, Texas.
Otol Neurotol. 2017 Oct;38(9):1296-1300. doi: 10.1097/MAO.0000000000001527.
To evaluate the audiometric outcomes following endoscopic ossicular chain reconstruction (OCR).
Retrospective case series.
Two tertiary referral centers.
Sixty two ears with ossicular discontinuity.
INTERVENTION(S): Endoscopic and microscopic OCR in patients with ossicular discontinuity.
Bone and air pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS).
Sixty two ears were included for analysis. Patients that underwent ossiculoplasty were subdivided based on prosthesis type (total ossicular replacement prosthesis [TORP] and partial ossicular replacement prosthesis [PORP], primary and staged ossiculoplasties, and surgical approach [microscopic and total endoscopic]). Forty two ears required PORP reconstructions, while 20 ears required TORP reconstructions. The microscope was used to reconstruct the ossicular chain in 31 cases, while an exclusive endoscopic approach was used in the remaining 31 patients. Controlling for the prosthesis, there were no significant postoperative differences in bone PTA, air PTA, and ABG between primary and staged ossiculoplasties, or surgical approach.
Controlling for the type of prosthesis, there were no significant differences in hearing outcomes with respect to staged ossicular chain reconstruction or whether the endoscope or microscope was used for visualization. Thus, in this series, endoscopic OCR yields similar audiometric outcomes when compared with microscopic OCR.
评估内镜下听骨链重建（OCR）后的听力测量结果。
回顾性病例系列。
两个三级转诊中心。
62例存在听骨链中断的耳。
对听骨链中断患者进行内镜和显微镜下的OCR。
骨导和气导纯音平均听阈（PTA）、气骨导差（ABG）和言语识别得分（WRS）。
纳入62耳进行分析。接受听骨成形术的患者根据假体类型（全听骨置换假体[TORP]和部分听骨置换假体[PORP]）、初次和分期听骨成形术以及手术入路（显微镜和全内镜）进行细分。42耳需要PORP重建，20耳需要TORP重建。31例使用显微镜重建听骨链，其余31例患者采用单纯内镜入路。在控制假体因素后，初次和分期听骨成形术或手术入路之间，术后骨导PTA、气导PTA和ABG无显著差异。
在控制假体类型的情况下，分期听骨链重建或使用内镜还是显微镜进行可视化操作，听力结果无显著差异。因此，在本系列研究中，与显微镜下OCR相比，内镜下OCR产生相似的听力测量结果。
