Harmat Kinga, Thurén Gergely, Simon László, Nepp Nelli, Németh Adrienn, Gerlinger Imre, Bakó Péter
Klinikai Központ, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs, Munkácsy Mihály u. 2., 7621.
Arc-, Állcsont- és Szájsebészeti Osztály, Markusovszky Egyetemi Oktatókórház Szombathely.
Orv Hetil. 2017 Sep;158(38):1503-1511. doi: 10.1556/650.2017.30843.
The reason of gradually developing conductive hearing loss in otosclerotic patients is the ossification of the stapes footplate to the surrounding bony structures and the therapy of stapes fixation is mainly surgical. In stapedotomy the footplate of the stapes is fenestrated with laser and microdrill in a diameter of 0.8 mm, whereas in stapedectomy there is complete removal of the footplate followed by the reconstruction of the ossicular chain. In the early postoperative period, temporary vertigo is frequently recorded which significantly influences the recovery.
In the Department of Otorhinolaryngology, University of Pécs both stapedectomy and stapedotomy were performed on a daily basis between 01.02.2010 and 15.03.2012. Our study focused on comparing the degree of postoperative vertigo after the two types of surgery. We hypothesized that the smaller fenestration of the stapes footplate during stapedotomy limits exposure to the inner ear reducing the severity of dizziness. Vertigo was evaluated subjectively with a retrospective questionnaire and objectively with static posturography.
On the 1st postoperative day, significantly fewer patients reported vertigo in the stapedotomy group and with significantly lower intensity. Results of the questionnaire regarding the later postoperative period showed no significant differences between the groups. Based on the analysis of the posturography test results, no significant difference was detected between the postoperative stability of the two groups. Results of the questionnaire and the posturography showed no correlation. Posturography test results did not confirm the presence of subjective vertigo.
Many factors may play a role in the development of vertigo after stapes surgery, but the type of intervention does not influence it. Orv Hetil. 2017; 158(38): 1503-1511.
耳硬化症患者逐渐出现传导性听力损失的原因是镫骨足板与周围骨质结构发生骨化，而镫骨固定的治疗主要是手术治疗。在镫骨开窗手术中，使用激光和微型钻头在镫骨足板上开出直径为0.8毫米的小孔，而在镫骨切除术则是完全切除足板，随后重建听骨链。在术后早期，经常会出现短暂性眩晕，这对恢复有显著影响。
在佩奇大学耳鼻喉科，2010年2月1日至2012年3月15日期间每天都进行镫骨切除术和镫骨开窗手术。我们的研究重点是比较这两种手术术后眩晕的程度。我们假设镫骨开窗手术中镫骨足板较小的开窗限制了对内耳的暴露，从而减轻了头晕的严重程度。通过回顾性问卷主观评估眩晕情况，并通过静态姿势描记法进行客观评估。
术后第1天，镫骨开窗手术组报告眩晕的患者明显较少，且强度明显较低。关于术后后期的问卷结果显示两组之间无显著差异。基于姿势描记测试结果的分析，两组术后稳定性之间未检测到显著差异。问卷结果和姿势描记法之间无相关性。姿势描记测试结果未证实存在主观眩晕。
镫骨手术后眩晕的发生可能涉及多种因素，但干预类型对此并无影响。《匈牙利医学周报》2017年；158(38):1503 - 1511。
