Department of Otolaryngology-Head and Neck Surgery, The Bill Wilkerson Center for Otolaryngology & Communication Sciences, Vanderbilt University, Nashville, Tennessee.
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina.
Otol Neurotol. 2018 Jul;39(6):e453-e460. doi: 10.1097/MAO.0000000000001795.
To report short (∼4 mo) and long-term (>12 mo) audiometric outcomes following ossiculoplasty using a titanium clip partial ossicular reconstruction prosthesis.
Case series at a single tertiary referral center reviewing 130 pediatric and adult patients with conductive hearing loss (CHL) secondary to chronic otitis media (n = 121, 93%) or traumatic ossicular disruption (n = 9, 7%) who underwent partial ossiculoplasty from January 2005 to December 2015 with the CliP prosthesis.
At both short and long-term follow-up, postoperative air-bone gap (ABG) was significantly improved (18 dB HL, IQ range 13-26, p < 0.0001 and 18 dB HL, IQ range 13-29, p = 0.0002, respectively) when compared with preoperative values (29 dB HL, IQ range 19-37). No significant change in ABG was noted when comparing short and long-term intervals (18 versus 18 dB HL, p = 0.44). Fifty seven percent of cases (51/89) achieved a long-term ABG less than or equal to 20 dB at the time of their last follow-up. The extrusion and displacement rates were 1.5% (2/130), and 0.8% (1/130), respectively. There were no cases of iatrogenic sensorineural hearing loss.
Partial ossiculoplasty with the titanium CliP produces good hearing outcomes with a favorable safety profile. At long-term follow-up (minimum of 12 mo), median ABG was 18 dB and remained stable when compared with short-term follow-up. The majority of patients had successful long-term results, with 57% of patients achieving an ABG is less than or equal to 20 dB. Low rates of extrusion (1.5%) and prosthesis displacement off the stapes (0.8%) support the long-term stability of the CliP prosthesis in the middle ear.
报告使用钛夹部分听骨重建假体进行鼓室成形术后的短期（约 4 个月）和长期（>12 个月）听力结果。
单中心回顾性病例系列研究，纳入 2005 年 1 月至 2015 年 12 月期间因慢性中耳炎（n=121，93%）或外伤性听骨链中断（n=9，7%）接受钛夹部分听骨重建假体鼓室成形术的 130 例儿童和成人患者。
与术前相比，术后短期（18dBHL，IQ 范围 13-26，p<0.0001）和长期（18dBHL，IQ 范围 13-29，p=0.0002）的气骨导差均明显改善。与短期相比，长期随访时气骨导差无明显变化（18 与 18dBHL，p=0.44）。57%（51/89）的患者在最后一次随访时达到长期气骨导差≤20dB。钛夹的脱出和移位率分别为 1.5%（2/130）和 0.8%（1/130）。无一例出现医源性感音神经性听力损失。
使用钛夹部分听骨重建假体行鼓室成形术可获得良好的听力效果，安全性较好。在长期随访（至少 12 个月）时，中位气骨导差为 18dB，与短期随访相比无明显变化。大多数患者获得了成功的长期结果，57%的患者气骨导差≤20dB。钛夹的脱出率（1.5%）和假体从砧骨上的移位率（0.8%）均较低，表明钛夹假体在中耳具有长期稳定性。
