Bajin Münir Demir, Ergün Onur, Çınar Betül Çiçek, Sennaroğlu Levent
Department of Otorhinolaryngology-Head and Neck Surgery, Hacettepe University School of Medicine, Ankara, Turkey.
Department of Otorhinolaryngology-Head and Neck Surgery, Ankara Training and Research Hospital, Ankara, Turkey.
Turk Arch Otorhinolaryngol. 2020 Mar;58(1):35-40. doi: 10.5152/tao.2020.4600. Epub 2019 Jul 6.
The aim of this report is to share our experience and treatment outcomes with far-advanced otosclerosis (FAO) patients.
Patients that underwent surgery from 2003 through 2014 at a tertiary referral center were retrospectively reviewed. Nineteen FAO patients were included in the study. Audiological results and the ability to communicate face to face and over telephone were considered as the main outcome measures.
Six FAO patients benefited well from stapedotomy with an average of 5.9-decibel (dB) air-bone gap and 86% median speech discrimination. Cochlear implantation (CI) was performed in 13 patients; two had disease progression after stapedotomy, five had failed stapes surgeries elsewhere, and six preferred CI as primary treatment. Median speech discrimination score of CI patients was 78.4%. Overall, all patients had satisfactory face-to-face communication and 90% could use telephone.
Bilateral stapedotomy and wearing hearing aid is an effective and cost-effective solution for restoring natural binaural hearing and requires no specific training. Should stapedotomy fail, cochlear implantation is always a successful back-up option.
本报告旨在分享我们对极重度耳硬化症（FAO）患者的治疗经验及治疗结果。
回顾性分析2003年至2014年在一家三级转诊中心接受手术的患者。本研究纳入了19例FAO患者。听力结果以及面对面和通过电话交流的能力被视为主要结局指标。
6例FAO患者行镫骨切除术效果良好，平均气骨导差为5.9分贝（dB），言语辨别中位数为86%。13例患者接受了人工耳蜗植入（CI）；2例在镫骨切除术后病情进展，5例在其他地方镫骨手术失败，6例更倾向于将CI作为主要治疗方法。CI患者的言语辨别分数中位数为78.4%。总体而言，所有患者的面对面交流都令人满意，90%的患者可以使用电话。
双侧镫骨切除术及佩戴助听器是恢复自然双耳听力的有效且经济高效的解决方案，且无需特殊训练。如果镫骨切除术失败，人工耳蜗植入始终是一个成功的备用选择。
