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镫骨手术可显著提高生活质量,与手术方法无关:使用不同赝复物和不同生活质量测量方法评估镫骨手术。

Stapes surgery leads to significant improvement in quality of life, independently from the surgical method: evaluation of stapes surgery using different prostheses and different quality of life measurements.

机构信息

Department of Oto-Rhino-Laryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2019 Nov;276(11):2975-2982. doi: 10.1007/s00405-019-05577-4. Epub 2019 Aug 19.

Abstract

OBJECTIVES

To compare quality-of-life (QoL) measurements with audiological results after stapes surgery with two different prostheses.

METHODS

This is a retrospective longitudinal study. All patients required stapes surgery for otosclerosis and ossicular chain reconstruction with either a titanium band prothesis (TBP) or receiving a nitinol head prosthesis (NHP). Intervention was between January 2011 and March 2017 patients received stapes-surgery with either TBP (n = 95) or NHP (n = 50). Audiological measurements at three different time points (preoperatively, early follow up < 3 months, late follow-up > 3 months) were compared and two different QoL-inventories, the Glasgow-Benefit-Inventory (GBI) and the Stapes-Plasty-Outcome-Test-25 (SPOT-25) were investigated postoperatively. The main outcome measures were Pure tone average (PTA) at 0.5, 1, 2, 3 kHz at early and late follow up after stapes surgery were compared and correlated with the subjective benefit on the QoL inventories. The perforation method and the type of surgery were analyzed as potentially influencing factors.

RESULTS

All patients showed a significantly reduced air bone gap (ABG 0.5, 1, 2, 3) at the two follow-up visits (visit 2: mean: 13.6 dB, SD 7.7; visit 3: mean: 12.7 dB SD 8.1) compared to preoperative measurements (mean: 28.9 dB, SD 9.9) and subjectively benefitted from stapes surgery (mean GBI score: 21.55; SD 20.60, mean SPOT-25 score: 28.03; SD 18.53). The outcome of the two questionnaires correlated with each other. Neither the hearing-outcome nor the subjective benefit was significantly influenced by the prosthesis, the perforation method or the type of anesthesia.

CONCLUSIONS

Both prostheses were safe and led to comparable hearing results as well as to subjective benefits in the Health-related-Quality-of-Life (HrQoL). A combination of the two questionnaires is recommendable for postoperative quality control.

摘要

目的

比较两种不同人工镫骨假体施行镫骨手术后患者的生活质量(QoL)测量结果与听力学结果。

方法

这是一项回顾性纵向研究。所有患者因耳硬化症和听骨链重建而需要进行镫骨手术,使用的人工镫骨假体分别为钛带假体(TBP)或镍钛诺人工镫骨(NHP)。干预措施于 2011 年 1 月至 2017 年 3 月间进行,共 95 例患者接受 TBP 手术,50 例患者接受 NHP 手术。在三个不同时间点(术前、早期随访<3 个月、晚期随访>3 个月)比较听力学测量结果,并在术后使用两种不同的生活质量调查问卷(格拉斯哥受益量表(GBI)和镫骨成形术结局测试 25 项(SPOT-25))进行调查。主要观察指标为镫骨手术后早期和晚期随访时的纯音平均听阈(0.5、1、2、3 kHz),并与生活质量调查问卷的主观获益相关。分析穿孔方法和手术类型是否为潜在影响因素。

结果

所有患者在两次随访时(随访 2:平均 13.6dB,标准差 7.7;随访 3:平均 12.7dB,标准差 8.1)的气骨导间隙均明显缩小(0.5、1、2、3 kHz),与术前测量值(平均 28.9dB,标准差 9.9)相比,以及与患者主观上受益于镫骨手术相比(平均 GBI 评分:21.55;标准差 20.60,平均 SPOT-25 评分:28.03;标准差 18.53)。两个问卷的结果相互关联。假体、穿孔方法或麻醉类型均未显著影响听力结果或主观获益。

结论

两种假体均安全有效,均可带来可比的听力结果和健康相关生活质量(HrQoL)的主观获益。建议联合使用这两个问卷进行术后质量控制。

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