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镫骨手术中二极管激光与手动穿孔的短期听力学结果比较

Short-Term Audiological Results of Diode Laser in Comparison with Manual Perforation in Stapes Surgery.

作者信息

Hamerschmidt Rogerio, Saab Stephanie Sbizera, Carvalho Bettina, Carmo Carolina do

机构信息

Department of ENT, Instituto Paranaense de Otorrinolaringologia (IPO), Curitiba, PR, Brazil.

Department of ENT, Universidade Federal do Paraná, Curitiba, PR, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2018 Apr;22(2):119-124. doi: 10.1055/s-0037-1602703. Epub 2017 May 17.

Abstract

Diode laser is a new alternative in stapes surgery for otosclerosis. The present study is the first to compare the short-term results of the surgery performed using diode laser to those obtained through the conventional fenestration technique.  To use audiometry to establish a comparative analysis between the functional results obtained through surgery for otosclerosis using diode laser and the conventional technique.  Audiometric evaluation of 12 patients submitted to stapes surgery for otosclerosis, using diode laser or conventional fenestration by needle and drills, between 2014 and 2015. Each group was composed of 6 patients. Pre and post-operative measures were compared for three months in both groups. The speech recognition threshold, the air and bone conduction threshold, as well as the gap between them at 500 Hz, 1 KHz, 2 KHz and 4 KHz were measured.  Significant difference in bone conduction and SRT was observed when compared post- and preoperative results in the diode group. However diode and conventional technique groups presented significant differences in air conduction and air-bone gap, suggesting that both can provide functional improvement.  Laser stapedotomy is a safe technique with good results. Both laser surgery and the conventional technique have improved the hearing of patients with a discreet advantage for the diode laser. Further prospective and randomized clinical trials are required to disclose all possible benefits of the stapes surgery using diode laser.

摘要

二极管激光是耳硬化症镫骨手术中的一种新选择。本研究首次比较了使用二极管激光进行手术与通过传统开窗技术获得的短期手术结果。

使用听力测定法对通过二极管激光和传统技术进行耳硬化症手术所获得的功能结果进行比较分析。

对2014年至2015年间接受耳硬化症镫骨手术的12例患者进行听力测定评估,其中6例使用二极管激光,6例使用传统的针钻开窗技术。两组均对术后三个月的术前和术后测量结果进行比较。测量了言语识别阈值、气导和骨导阈值,以及它们在500Hz、1kHz、2kHz和4kHz时的差值。

与二极管组术前结果相比,术后骨导和言语识别阈值有显著差异。然而,二极管组和传统技术组在气导和气骨间隙方面存在显著差异,这表明两者都能改善功能。

激光镫骨足板切除术是一种安全且效果良好的技术。激光手术和传统技术都改善了患者的听力,二极管激光具有一定优势。需要进一步进行前瞻性和随机临床试验,以揭示使用二极管激光进行镫骨手术的所有潜在益处。

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