Skarżyński Henryk, Kordowska Kamila, Skarżyński Piotr H, Gos Elżbieta
Otorhinolaryngology Surgery Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Mochnackiego 10, 02-042 Warsaw, Poland.
Otorhinolaryngology Surgery Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Mochnackiego 10, 02-042 Warsaw, Poland.
Auris Nasus Larynx. 2019 Dec;46(6):853-858. doi: 10.1016/j.anl.2019.04.001. Epub 2019 Apr 18.
This is a retrospective study of hearing results and characteristics of osteogenesis imperfecta (OI) patients treated for hearing loss by stapedotomy at tertiary reference center.
This study enrolled 20 patients with a clinical diagnosis of OI- (11M:9F). 18 patients (90%) underwent surgery due to hearing loss in the period 2003-16. The audiometric analysis provides the pure tone audiometry results of stapedotomy in adult patients in 2 periods (≤12 months and >12 months). Air-bone gap (ABG), hearing gain (HG), and changes in air and bone conduction thresholds after surgical treatment were analyzed.
In short-time follow-up we noted statistically significant improvement in mean AC thresholds and ABG (p < 0.001 for both), change in mean BC thresholds was statistically negligible. Comparing the observation periods short-term and long-term, it was found that AC thresholds, ABG, HG, ABG closure did not significantly change, although BC thresholds and BC closure deteriorated significantly (p < 0.05).
Stapes surgery for OI can be considered as a method of treating the conductive and/or mixed hearing loss suffered by these patients; however, the surgery is more difficult than that for otosclerosis because OI cases often have extremely difficult anatomical conditions. The hearing results of OI stapes surgery differ from typical otosclerosis cases, with the ABG closure not being as good. In addition, sensorineural hearing loss inevitably progresses.
这是一项在三级转诊中心对接受镫骨手术治疗听力损失的成骨不全(OI)患者的听力结果和特征进行的回顾性研究。
本研究纳入了20例临床诊断为OI的患者(11例男性:9例女性)。18例患者(90%)在2003年至2016年期间因听力损失接受了手术。听力分析提供了成年患者在两个时间段(≤12个月和>12个月)镫骨手术的纯音听力测定结果。分析了气骨导差(ABG)、听力增益(HG)以及手术治疗后气导和骨导阈值的变化。
在短期随访中,我们注意到平均气导阈值和ABG有统计学上的显著改善(两者p均<0.001),平均骨导阈值的变化在统计学上可忽略不计。比较短期和长期观察期,发现气导阈值、ABG、HG、ABG闭合没有显著变化,尽管骨导阈值和骨导闭合显著恶化(p<0.05)。
OI的镫骨手术可被视为治疗这些患者传导性和/或混合性听力损失的一种方法;然而,该手术比耳硬化症手术更困难,因为OI病例的解剖条件往往极其困难。OI镫骨手术的听力结果与典型耳硬化症病例不同,ABG闭合效果不佳。此外,感音神经性听力损失不可避免地会进展。