Sato Shin-Ichi, Takagi Akira, Fujiwara Takashi
Department of Otolaryngology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki City, Okayama Prefecture, 710-8602, Japan.
Department of Otolaryngology, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-ku, Shizuoka City, Shizuoka Prefecture, 420-8527, Japan.
Auris Nasus Larynx. 2018 Dec;45(6):1178-1182. doi: 10.1016/j.anl.2018.05.004.
The aim of this study was to evaluate the hearing outcomes and complications of stapedotomy in which the stapes superstructure was preserved (Takagi's stapedotomy). In this surgical approach, the lenticular process of the incus rather is removed, than the superstructure of the stapes.
A single-center retrospective observational study was performed. We included all patients having Takagi's stapedotomy for otosclerosis between January 2005 and April 2016. Both primary and revision stapes surgery were included. We evaluated audiometric outcomes and surgical complications.
Twenty-four patients who underwent stapedotomy preserving superstructure were included in this study. The postoperative air-bone gap at 1year postoperatively was ≤10dB in 66.7% of patients and ≤20dB in all cases. In longer follow-up period, elevation of the air-bone gap was not observed over the 5 postoperative years in available cases. The postoperative air-bone gap was ≤10dB in 72.2% at 3years and 81.8% at 5years postoperatively.
Takagi's stapedotomy restore ossicular conduction without the removal of superstructure of stapes. The air-bone gap did not get worse in long-term follow-up, although audiometric results would be unsatisfactory. Further larger studies are needed to evaluate the efficacy and safety of Takagi's stapedotomy.
本研究旨在评估保留镫骨上部结构的镫骨切除术(高木式镫骨切除术)的听力结果及并发症。在这种手术方法中,切除的是砧骨的豆状突,而非镫骨的上部结构。
进行了一项单中心回顾性观察研究。纳入2005年1月至2016年4月期间所有因耳硬化症接受高木式镫骨切除术的患者。初次和翻修镫骨手术均包括在内。我们评估了听力测定结果和手术并发症。
本研究纳入了24例行保留上部结构镫骨切除术的患者。术后1年气骨导差≤10dB的患者占66.7%,所有病例气骨导差均≤20dB。在更长的随访期内,现有病例术后5年未观察到气骨导差升高。术后3年气骨导差≤10dB的患者占72.2%,术后5年占81.8%。
高木式镫骨切除术在不切除镫骨上部结构的情况下恢复了听骨传导。尽管听力测定结果可能不尽人意,但长期随访中气骨导差并未恶化。需要进一步开展更大规模的研究来评估高木式镫骨切除术的疗效和安全性。