Chaudhary Shashank, Prasad K C
M.S Otorhinolaryngology and Head and Neck Surgery, House Number 747, Sector 21 -A, Faridabad, Haryana 121001 India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1396-1401. doi: 10.1007/s12070-018-1478-1. Epub 2018 Aug 25.
Chronic otitis media (COM) may lead to partial or complete loss of tympanic membrane and erosion of the ossicles. Ossicular chain reconstruction may be done by interposition ossiculoplasty or myringostapediopexy. The aim of our study was to determine the hearing outcome in interposition ossiculoplasty and myringostapediopexy using autologous incus or cortical bone graft in intact canal wall tympanoplasty. 64 patients with COM, who underwent interposition ossiculoplasty or myringostapediopexy were included in the study. Audiometric evaluation was done after 3 months after surgery and all patients were followed up for a period of 1 year. The hearing results were compared in terms of mean pre-op and post-op Air conduction thresholds, Air-Bone gap (ABG) and hearing gain or ABG closure. In this study the mean ABG closure for interposition ossiculoplasty and myringostapediopexy was 15.4 dB and 21.8 dB, respectively. Hearing gain with cortical bone graft was higher than hearing gains with incus in both the groups, but not statistically significant. Myringostapediopexy provides marginally better hearing gain compared to interposition ossiculoplasty. Aulogous incus, and cortical bone graft are suitable autologous materials for ossicular reconstruction and provide similar hearing outcome.
慢性中耳炎（COM）可能导致鼓膜部分或完全丧失以及听小骨侵蚀。听骨链重建可通过植入式听骨成形术或鼓膜镫骨固定术完成。我们研究的目的是确定在完整外耳道壁鼓室成形术中使用自体砧骨或皮质骨移植进行植入式听骨成形术和鼓膜镫骨固定术的听力结果。64例接受植入式听骨成形术或鼓膜镫骨固定术的COM患者被纳入研究。术后3个月进行听力评估，所有患者随访1年。根据术前和术后平均气导阈值、气骨导间距（ABG）以及听力增益或ABG闭合情况比较听力结果。在本研究中，植入式听骨成形术和鼓膜镫骨固定术的平均ABG闭合分别为15.4dB和21.8dB。两组中使用皮质骨移植的听力增益均高于使用砧骨的听力增益，但无统计学意义。与植入式听骨成形术相比，鼓膜镫骨固定术的听力增益略好。自体砧骨和皮质骨移植是适合听骨重建的自体材料，且听力结果相似。
