Crutcher W L, Tassone P, Pelosi S
Department of Otolaryngology,Thomas Jefferson University,Philadelphia,Pennsylvania,USA.
J Laryngol Otol. 2018 Oct;132(10):858-865. doi: 10.1017/S0022215118001494. Epub 2018 Oct 5.
To compare post-operative audiometric outcomes for the two prevailing surgical approaches for isolated malleus and/or incus fixation: ossicular mobilisation with preservation of the ossicular chain, and disruption and reconstruction of the ossicular chain.
A search was conducted, in December 2016, of PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature articles written in English. Papers presenting original data regarding post-operative audiometric outcomes in patients who underwent surgical treatment for malleus and/or incus fixation with a mobile and intact stapes were included. A risk of bias assessment was performed on the 14 selected papers and a tier system was developed. Meta-analysis was accomplished by comparing pooled rates of surgical success by chi-square test and calculating odds ratios by logistical regression. Analysis was performed using Revman5 and R software.Results and conclusionAnalysis of the literature revealed no differences in audiometric outcomes between ossicular chain mobilisation and ossicular chain reconstruction in patients with isolated malleus and/or incus fixation. A large, prospective study comparing both short- and long-term hearing results for ossicular chain mobilisation and ossicular chain reconstruction in this population may identify whether a difference in outcomes exists between the two approaches.
比较孤立性锤骨和/或砧骨固定的两种主要手术方法术后的听力测定结果：保留听骨链的听骨活动术，以及听骨链中断与重建术。
2016年12月检索了以英文撰写的PubMed、Scopus以及护理学与健康相关文献累积索引中的文章。纳入了关于接受锤骨和/或砧骨固定手术治疗且镫骨活动且完整的患者术后听力测定结果的原始数据论文。对14篇选定论文进行了偏倚风险评估并建立了分级系统。通过卡方检验比较手术成功率的合并率并通过逻辑回归计算比值比来完成荟萃分析。使用Revman5和R软件进行分析。结果与结论文献分析显示，孤立性锤骨和/或砧骨固定患者中，听骨链活动术与听骨链重建术在听力测定结果上无差异。一项比较该人群听骨链活动术和听骨链重建术短期和长期听力结果的大型前瞻性研究，可能会确定这两种方法在结果上是否存在差异。
