Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
Laryngoscope. 2020 Mar;130(3):790-796. doi: 10.1002/lary.28072. Epub 2019 May 20.
OBJECTIVES/HYPOTHESIS: The aim of this study was to investigate different stapes surgery techniques in relation to hearing outcome and risk for complications such as tinnitus, hearing deterioration, dizziness, and taste disturbance.
Retrospective database review.
The study was based on data from the Swedish Quality Register for Otosclerosis Surgery (SQOS). Two study protocols were completed by the surgeon, and a questionnaire was distributed to each patient 1 year after surgery. A total of 832 patients operated on during 2013 to 2016 were included. Pure-tone audiometry was performed preoperatively and 1 year after surgery.
There was no significant difference in postoperative high-frequency hearing thresholds among the subgroups at the 1-year follow-up. The CO + drill laser group had the best hearing outcome according to the following criteria: air-bone gap closure ≤10 dB, air-conduction improvement >20 dB, and bone conduction not worsened >5 dB. The overall complication rate was low in all analyzed groups. The most commonly reported symptom after surgery was newly developed or worsened tinnitus (6%). Subjective hearing 1 year after surgery was reported to be better or much better in 91% of the patients.
The combination of a drill and CO laser or a drill and potassium-titanyl-phosphate laser resulted in the best hearing outcome in this study from the SQOS. There were no major differences in high-frequency hearing outcome when comparing the different surgical techniques. Complications from surgery were rare, and patient satisfaction was very high 1 year after the operation.
NA Laryngoscope, 130:790-796, 2020.
目的/假设：本研究旨在探讨不同镫骨手术技术与听力结果及并发症风险（如耳鸣、听力下降、头晕和味觉障碍）的关系。
回顾性数据库研究。
该研究基于瑞典耳硬化症手术质量登记处（SQOS）的数据。由外科医生完成了两项研究方案，并在手术后 1 年向每位患者分发了一份问卷。共纳入 2013 年至 2016 年期间接受手术的 832 例患者。术前和术后 1 年均行纯音测听。
在术后 1 年的随访中，各亚组间高频听力阈值无显著差异。CO+钻头激光组根据以下标准具有最佳听力结果：气骨导差<10dB，气导提高>20dB，骨导不恶化>5dB。所有分析组的并发症发生率均较低。术后最常见的症状是新出现或恶化的耳鸣（6%）。91%的患者报告术后 1 年听力较术前或明显改善。
在 SQOS 中，钻头联合 CO 激光或钻头联合钾钛磷激光的组合效果最佳。比较不同手术技术时，高频听力结果无明显差异。手术并发症罕见，术后 1 年患者满意度非常高。
无。喉科学，130：790-796，2020 年。
