Chernushevich I I, Anikin I A, Agazaryan A G, Korneyenkov A A, Zakharova G P, Astashchenko S V
St.-Petersburg scientific research Institute of ear, throat, nose and speech, Bronnitskaya 9, St.-Petersburg, Russia, 190013.
Vestn Otorinolaringol. 2019;84(2):23-28. doi: 10.17116/otorino20198402123.
We used several variants of one-stage tympanoplasty, including our own method, according to which, in the absence of an anvil and malleus after mobilisation of the stapes, ossiculoplasty with partial or complete ossicular prosthesis and myringoplasty simultaneously preventively created a support (neo-malleus) in the thickness of the neotympanic membrane. To assess the effectiveness of different variants of single-stage tympanoplasty, the long-term functional results were compared in terms of 6 to 12 months after the intervention with preoperative indicators. Standard methods of statistical estimation with calculation of descriptive statistics and methods of statistical hypothesis testing based on nonparametric Wilcoxon criterion for related samples were used. All the variants of one-stage tympanoplasty used in the fixation of the stapes are effective and, in general, make it possible to achieve an improvement in auditory function. In the present study, this result was achieved in 61 of 86 patients with tympanosclerosis (71% (65%; 74%) of 95% CI). The functional results of tympanoplasty according to the developed method do not differ from the results of traditional variants with the use of prostheses, but the implementation of this variant of tympanoplasty in the absence of an anvil and hammer allows for the fixation of the stapes during the reoperative stapedotomy using a prosthesis of the piston type without additional surgical stage of the formation of the neomaleus.
我们采用了几种一期鼓室成形术的变体，包括我们自己的方法。根据我们的方法，在镫骨活动后砧骨和锤骨缺失的情况下，使用部分或完全听骨假体进行听骨成形术并同时进行鼓膜成形术，可在新鼓膜厚度中预防性地创建一个支撑物（新锤骨）。为了评估单阶段鼓室成形术不同变体的有效性，将干预后6至12个月的长期功能结果与术前指标进行了比较。使用了计算描述性统计量的标准统计估计方法以及基于相关样本的非参数威尔科克森标准的统计假设检验方法。用于镫骨固定的所有一期鼓室成形术变体都是有效的，总体而言，能够实现听觉功能的改善。在本研究中，86例鼓室硬化症患者中有61例取得了这一结果（95%置信区间的71%（65%；74%））。根据所开发方法进行的鼓室成形术的功能结果与使用假体的传统变体结果无差异，但在没有砧骨和锤骨的情况下实施这种鼓室成形术变体，可在再次镫骨切开术中使用活塞型假体固定镫骨，而无需额外的新锤骨形成手术阶段。
