Zheng Y B, Hou Z H, Wang Z Y, Chen Y, Yang Q, Zhao Y
Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of the People's Liberation Army, Beijing 100853, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Apr 7;54(4):257-261. doi: 10.3760/cma.j.issn.1673-0860.2019.04.004.
To explore the efficacy of ossiculoplasty surgery under oto-endoscope in patients of conductive hearing loss with intact tympanic membrane. A retrospective study was conducted. The clinical data of 45 patients with conductive hearing loss who had undergone simple ossiculoplasty surgery between October 2015 and December 2017 from five hospitals in China (West China Hospital of Sichuan University, General Hospital of the People's Liberation Army, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Xijing Hospital, Fourth Military Medical University and Shenzhen Sixth People's Hospital) were collected. There were 28 males and 17 females, with the age ranging from 12 to 69 years old. The tympanic membranes of those patients were intact before surgery. The lesion only occurred in the ossicular chain from CT and intraoperative exploration. The cases of otosclerosis, tympanosclerosis, cholesteatoma of middle ear, chronic suppurative otitis media, and tumor of middle ear were excluded. The postoperative complications, hearing improvements and operation time were observed. SPSS 23.0 software was used for statistic analysis. There was neither sensorineural hearing loss nor facial paralysis after surgery in this group. Seven patients had transient mild tinnitus after surgery and gradually relieved during the follow-up period. Nine patients developed dysgeusia after surgery. Two patients developed dizziness after surgery, and the symptoms were mild and relieved during 1 week without special intervention. The air-bone gap (ABG) range of pre-operation was 22.5-45.7 dB, and the average ABG was (25.3±8.6) dB. The ABG range in the third month after surgery was 5.7-26.8 dB, and the average ABG was (9.3±8.6) dB. The mean value of ABG was significantly lower in the third month after surgery compared with that of pre-operation (2.31, 0.05). The operation time of the surgeons in each research center was similar. The overall average of operation time was (43.56±18.25) min. There was no significant difference in the duration of operation between the centers (3.26, 0.05). The ossiculoplasty surgery under oto-endoscope has good efficacy.
探讨耳内镜下听骨链重建术治疗鼓膜完整的传导性听力损失患者的疗效。进行一项回顾性研究。收集了2015年10月至2017年12月期间在中国五家医院(四川大学华西医院、中国人民解放军总医院、上海交通大学医学院附属第九人民医院、第四军医大学西京医院、深圳市第六人民医院)接受单纯听骨链重建术的45例传导性听力损失患者的临床资料。其中男性28例,女性17例,年龄12至69岁。这些患者术前鼓膜完整。根据CT及术中探查,病变仅累及听骨链。排除耳硬化症、鼓室硬化症、中耳胆脂瘤、慢性化脓性中耳炎及中耳肿瘤病例。观察术后并发症、听力改善情况及手术时间。采用SPSS 23.0软件进行统计学分析。该组患者术后未出现感音神经性听力损失及面瘫。7例患者术后出现短暂轻度耳鸣,随访期间逐渐缓解。9例患者术后出现味觉障碍。2例患者术后出现头晕,症状较轻,未经特殊干预1周内缓解。术前气骨导间距(ABG)范围为22.5 - 45.7 dB,平均ABG为(25.3±8.6)dB。术后第三个月ABG范围为5.7 - 26.8 dB,平均ABG为(9.3±8.6)dB。术后第三个月ABG平均值与术前相比显著降低(P = 2.31,P < 0.05)。各研究中心手术医生的手术时间相似。手术时间总体平均值为(43.56±18.25)分钟。各中心间手术时长无显著差异(P = 3.26,P > 0.05)。耳内镜下听骨链重建术疗效良好。