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先天性外耳道闭锁患者行闭锁成形术的长期效果

Long-term results of atresiaplasty in patients with congenital aural atresia.

作者信息

Pellinen Juuso, Vasama Juha-Pekka, Kivekäs Ilkka

机构信息

a Department of Otorhinolaryngology , Tampere University Hospital, and School of Medicine, University of Tampere , Tampere , Finland.

b Department of Otorhinolaryngology , Tampere University Hospital , Tampere , Finland.

出版信息

Acta Otolaryngol. 2018 Jul;138(7):621-624. doi: 10.1080/00016489.2018.1431402. Epub 2018 Feb 9.

Abstract

OBJECTIVES

To evaluate long-term benefits of atresiaplasty on hearing and the impact of surgery on quality of life (QoL) in congenital aural atresia (CAA) patients.

METHODS

We evaluated the long-term hearing results, the impact of atresiaplasty on QoL, the meatal diameter of the operated ear canal, and the cumulative number of post-operative hospital visits in 14 CAA patients, on average, 12 years (range: 4-17 years) post-operatively.

RESULTS

The mean preoperative pure tone average (PTA) was 61 dB HL. The postoperative short-term PTA was 36 dB HL and the long-term PTA was 51 dB HL. The mean total Glasgow Benefit Inventory (GBI) score was 16 (range: -11-39), showing the positive benefit of atresiaplasty on QoL. The mean postoperative diameter of the auditory meatus was 6 mm. The average number of hospital outpatient visits during the first postoperative year was 10.

CONCLUSION

Surgery for CAA is a demanding operation with variable anatomical and hearing outcomes. Atresiaplasty operations should be centralized to hospitals with large numbers of such patients to ensure sufficient levels of surgical experience. Bone-anchored hearing devices or middle-ear implants should be considered as a first-line option because they offer good hearing predictability.

摘要

目的

评估耳道闭锁成形术对先天性耳道闭锁(CAA)患者听力的长期益处以及手术对生活质量(QoL)的影响。

方法

我们评估了14例CAA患者术后平均12年(范围:4 - 17年)的长期听力结果、耳道闭锁成形术对生活质量的影响、手术侧耳道的直径以及术后累计住院就诊次数。

结果

术前平均纯音听阈(PTA)为61 dB HL。术后短期PTA为36 dB HL,长期PTA为51 dB HL。格拉斯哥效益量表(GBI)总评分平均为16分(范围:-11 - 39),表明耳道闭锁成形术对生活质量有积极益处。术后耳道平均直径为6 mm。术后第一年门诊就诊平均次数为10次。

结论

CAA手术是一项要求较高的手术,解剖和听力结果各异。耳道闭锁成形术应集中在有大量此类患者的医院进行,以确保足够的手术经验水平。骨锚式助听器或中耳植入物应被视为一线选择,因为它们具有良好的听力可预测性。

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