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[内镜镫骨手术的安全性和效果评估:一项多中心研究]

[Evaluation of the safety and effect of the endoscopic stapes surgery: a multi-center study].

作者信息

Yang Q, Zhao Y, Hou Z H, Chen S J, Yu Y J, Wang Z Y, Chen Y, Wang W Q

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen Sixth People's Hospital (Nanshan Hospital) , Shenzhen 518052, China.

Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Apr 7;54(4):262-266. doi: 10.3760/cma.j.issn.1673-0860.2019.04.005.

Abstract

To analyze the safety of endoscopic stapes surgery, and to compare the results with stapes surgery under microscopic approach. This was a retrospective study. One hundred and thirty seven patients from Eye Ear Nose and Throat Hospital of Fudan University and other seven hospitals were enrolled in this study. Eighty eight patients, in whom 29 were male, and 59 were female, aged from 29 to 66 years old, with an average of 40.1±10.7, underwent endoscopic stapedotomy and 49 patients, in whom 17 were male, and 33 were female, aged from 32 to 64 yeas old, with an arerage of 38.7±9.2, underwent microscopic stapedotomy for otosclerosis. Interventions included endoscopic and microscopic stapes surgeries. Main outcome measures consisted of operating time, preoperative and postoperative hearing, intraoperative findings, and postoperative complications. SPSS 16.0 software was used to analyzed the date ( test and χ(2) test) . Patients in the group who underwent endoscopic stapes surgery showed a mean operative time of (74.1±26.0) min. Patients in the group treated by microscopic approach had a mean operative time (66.5±15.9) min. Statistical difference was evident (1.279, 0.05) . The average operative time of endoscopic surgery became shorter as the cases increased. The average duration of the last 10 cases was shorter than that of the first 10 cases in both groups. The differences were significant ( value was 3.028, 3.610, both <0.05). No statistical difference was found in air conduction threshold improvement (1.074, 0.289) , air-bone gap closure (-0.135, 0.893) and bone conduction improvement (1.222, 0.228) between the two groups. No difference regarding the incidence of the postoperative complications (chorda tympanum damage: 6 cases 2 cases, χ(2)=0.08,0.05; vertigo:18 cases 9 cases,χ(2)=0.09, 0.05; facial paralysis: 0 case 0 case) between the two groups was found. Audiological outcomes achieved by endoscopic surgery are similar to the results obtained through a microscopic approach. Endoscopic stapes surgery is safe.

摘要

分析内镜下镫骨手术的安全性,并将结果与显微镜下镫骨手术进行比较。这是一项回顾性研究。来自复旦大学附属眼耳鼻喉科医院及其他七家医院的137例患者纳入本研究。88例患者接受了内镜下镫骨足板切除术,其中男性29例,女性59例,年龄29至66岁,平均40.1±10.7岁;49例患者接受了显微镜下镫骨手术治疗耳硬化症,其中男性17例,女性33例,年龄32至64岁,平均38.7±9.2岁。干预措施包括内镜和显微镜下镫骨手术。主要观察指标包括手术时间、术前和术后听力、术中发现及术后并发症。采用SPSS 16.0软件分析数据(检验和χ(2)检验)。接受内镜下镫骨手术组患者的平均手术时间为(74.1±26.0)分钟。显微镜下手术组患者的平均手术时间为(66.5±15.9)分钟。差异有统计学意义(1.279,0.05)。随着病例数增加,内镜手术的平均手术时间缩短。两组中最后10例的平均手术时间均短于前10例。差异有统计学意义(值分别为3.028、3.610,均<0.05)。两组在气导阈值改善(1.074,0.289)、气骨导间距缩小(-0.135,0.893)和骨导改善(1.222,0.228)方面均未发现统计学差异。两组术后并发症发生率(鼓索神经损伤:6例对2例,χ(2)=0.08,P>0.05;眩晕:18例对9例,χ(2)=0.09,P>0.05;面瘫:0例对0例)无差异。内镜手术获得听力学结果与显微镜下手术相似。内镜下镫骨手术是安全的。

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