Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India.
Laryngoscope. 2020 Mar;130(3):797-802. doi: 10.1002/lary.28074. Epub 2019 May 23.
OBJECTIVES/HYPOTHESIS: To compare endoscopic ossiculoplasty with conventional microscopic technique in terms of postoperative hearing outcomes and complications.
Randomized controlled trial.
One hundred eighteen patients diagnosed with ossicular chain discontinuity were randomly assigned into two groups, one undergoing endoscopic ossiculoplasty and the other undergoing ossiculoplasty by the microscopic technique, with the operating surgeon being same for both groups. The two groups were compared in terms of operative time, postoperative air-bone gap, mean air-bone gap closure, and incidence of complications. Teflon prostheses (partial ossicular chain replacement prosthesis [PORP] and total ossicular chain replacement prosthesis [TORP]) were used for reconstruction in all cases.
Endoscopic ossiculoplasty with PORP rendered a statistically significant mean postoperative air-bone gap and air-bone gap closure at 1 month when compared to that of microscopic PORP ossiculoplasty. However, there was no significant difference between the two techniques in terms of mean postoperative air-bone gap and air-bone gap closure at 3 and 6 months. In the TORP ossiculoplasty cases, there was no significant difference in mean postoperative air-bone gap and air-bone gap closure at 1, 3, and 6 months. In terms of operative time and incidence of complications, no statistical significance was found between the two groups.
Endoscopic ossiculoplasty appears to provide superior visualization and better early audiological outcome (in PORP ossiculoplasty cases) when compared to microscopic technique. However, long-term audiological outcomes and incidence of complications remain comparable.
1 Laryngoscope, 130:797-802, 2020.
目的/假设：比较内镜听骨链重建术与传统显微镜技术在术后听力结果和并发症方面的差异。
随机对照试验。
将 118 例诊断为听骨链中断的患者随机分为两组，一组行内镜听骨链重建术，另一组行显微镜下听骨链重建术，两组的手术医生相同。比较两组手术时间、术后气骨导差、气骨导差平均闭合率及并发症发生率。所有病例均采用聚四氟乙烯（PORP 和 TORP）假体进行重建。
与显微镜下 PORP 听骨链重建术相比，内镜 PORP 听骨链重建术在术后 1 个月时的平均气骨导差和气骨导差闭合率有统计学意义。但在术后 3 个月和 6 个月时，两种技术的平均气骨导差和气骨导差闭合率无显著差异。在 TORP 听骨链重建病例中，1 个月、3 个月和 6 个月时的平均气骨导差和气骨导差闭合率无显著差异。在手术时间和并发症发生率方面，两组之间无统计学差异。
与显微镜技术相比，内镜听骨链重建术在 PORP 听骨链重建病例中提供了更好的可视化效果和更好的早期听力结果。然而，长期的听力结果和并发症发生率仍相当。
1 项喉镜，130:797-802，2020 年。
