Feng N Y, Shen X L, Wang Y X, Wen W L, Guo H Q
Department of Otolaryngology Head and Neck Surgery,General Hospital of Ningxia Medical University,750004,Yinchuan,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Oct 5;32(19):1499-1501. doi: 10.13201/j.issn.1001-1781.2018.19.014.
A series of otitis media patients with Austin A and C type ossicles defects received ossicular chain reconstruction surgery using either autologous incus or titanium partial ossicular replacement prosthesis (PORP).The hearing outcomes and exclusion rate of prosthesis were compared between these two groups. One hundred and seventy-six patients with chronic otitis media underwent ossiculoplasty in our hospital during 2016-2017. These patients were divided into 2 groups: group A consisted of those receiving autologous incus replacement (n=85), and group B consisted of those receiving titanium PORP (n=91). All the patients received CWD mastoidectomy and ossiculoplasty in one stage and were followedup in postoperative 3, 6 and 12 months. The postoperative hearing improvement rates in group A and B were 85.88% and 92.31%, respectively, and there was no statistical difference. No statistical difference of the postoperative hearing improvement rates was observed between Austin A and C type in 2 groups. Three cases (3.29%) had ossicle exclusion in B group, and 0 case in A group, which was not statistical different (>0.05). Patients receiving ossicular chain reconstruction surgery using autologous incus show similar hearing outcomes as those using titanium PORP. The risk of prosthesis exclusion is lower for autologous incus than titanium PORP. The residual handle of malleus has no obvious influence on the postoperative hearing improvement.
一系列患有奥斯汀A和C型听小骨缺损的中耳炎患者接受了使用自体砧骨或钛质部分听骨置换假体(PORP)的听骨链重建手术。比较了这两组患者的听力结果和假体排斥率。2016年至2017年期间,我院有176例慢性中耳炎患者接受了听骨成形术。这些患者被分为两组:A组为接受自体砧骨置换的患者(n = 85),B组为接受钛质PORP的患者(n = 91)。所有患者均一期接受了完壁式乳突根治术和听骨成形术,并在术后3、6和12个月进行随访。A组和B组术后听力改善率分别为85.88%和92.31%,差异无统计学意义。两组中奥斯汀A和C型患者术后听力改善率差异无统计学意义。B组有3例(3.29%)出现听小骨排斥,A组为0例,差异无统计学意义(>0.05)。使用自体砧骨进行听骨链重建手术的患者与使用钛质PORP的患者听力结果相似。自体砧骨的假体排斥风险低于钛质PORP。锤骨残余柄对术后听力改善无明显影响。