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耳硬化症的临床特征及镫骨切除术的疗效:我们48例患者(58耳)的经验

The clinical characteristics of otosclerosis and benefit from stapedotomy: our experience of 48 patients (58 ears).

作者信息

Xie Jing, Zhang Ling-Jun, Zeng Na, Liu Yun, Gong Shu-Sheng

机构信息

Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University , Beijing , China.

Clinical Epidemiology and EBM Center, Beijing Friendship Hospital, Capital Medical University , Beijing , China.

出版信息

Acta Otolaryngol. 2019 Oct;139(10):843-848. doi: 10.1080/00016489.2019.1649459. Epub 2019 Aug 22.

Abstract

Stapedotomy has been proved to be one of the most efficient procedure to treat otosclerosis, various factors contribute to the diversity of the outcomes and controversial results exist from previous studies. We evaluated clinical characteristics and outcomes of stapedotomy, as well as possible predictive factors of a successful outcome. This retrospective study evaluated 58 ears from 48 patients with demographic data, plus short-term follow-up of hearing outcomes of 28 ears, and evaluated variables using univariate general linear regression analyses. The average operation age was 41.54 years. A total of 87.5% (42/48) patients presented with bilateral otosclerosis. 39.66% (23/58) ears had CT finding before the surgery. Patients with persistent tinnitus accounted for 53.45% (31/58) and the average preoperative ABG of the 58 ears was 32.22 dB. We achieved good postoperative air-bone gaps (ABGs) overall but poor ABG closure at 4 kHz. No predictive factors were identified in the 28 ears that were followed up. Delayed surgery may be attributable to insufficient recognition of otosclerosis. The fenestration size could be the reason for poor ABG closure at high frequency. However, more cases and longer follow-ups are required to confirm our findings.

摘要

镫骨切除术已被证明是治疗耳硬化症最有效的手术方法之一,多种因素导致了结果的多样性,并且先前的研究存在有争议的结果。我们评估了镫骨切除术的临床特征和结果,以及成功结果的可能预测因素。这项回顾性研究评估了48例患者的58只耳朵的人口统计学数据,以及对28只耳朵听力结果的短期随访,并使用单变量一般线性回归分析评估变量。平均手术年龄为41.54岁。共有87.5%(42/48)的患者患有双侧耳硬化症。39.66%(23/58)的耳朵在手术前有CT检查结果。持续性耳鸣患者占53.45%(31/58),58只耳朵术前平均气骨导差(ABG)为32.22dB。总体而言,我们术后获得了良好的气骨导差,但在4kHz时气骨导差闭合不佳。在随访的28只耳朵中未发现预测因素。手术延迟可能归因于耳硬化症认识不足。开窗大小可能是高频气骨导差闭合不佳的原因。然而,需要更多病例和更长时间的随访来证实我们的发现。

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