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[耳硬化性听骨链固定的临床方面]

[Clinical aspects of otosclerotic ossicular chain fixations].

作者信息

Kriston Fanni, Rovó László, Kiss József Géza, Jarabin János András

机构信息

Fül-Orr-Gégészeti és Fej-Nyaksebészeti Osztály,Jahn Ferenc Dél-pesti Kórház és Rendelőintézet Budapest.

Általános Orvostudományi Kar, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika,Szegedi Tudományegyetem Szeged.

出版信息

Orv Hetil. 2020 May;161(19):780-788. doi: 10.1556/650.2020.31701.

DOI:10.1556/650.2020.31701
PMID:32365050
Abstract

Otosclerosis is a human-specific ear disease characterised by complex bone-remodelling with multifactorial aetiology. It affects the bony labyrinth capsule and consequently fixates the stapes to the oval window rim. The fixation of the ossicular chain leads to a decrease in the middle ear's acoustic impedance-fitting and amplifier function that leads to conductive hearing loss. The process is progressive and when it involves the inner ear structures, it deteriorates the sensorineural function as well. The course of the illness can be prevented or delayed if hearing reconstructive surgery is performed on time. The development of stapes surgery spans the 20th century, and despite the major surgical steps - laid down by Shea and Marquet in the 1960s - are quite conservative, fine adjustments are still being made mainly due to technical progress. Several studies confirm that stapedotomy remained the first-to-offer therapeutic option in otosclerosis. With an adequate surgical technique, significant improvement can be achieved in the air conduction threshold, the air-bone gap may be minimalized or ceased over the speech frequencies, which significantly improves the quality of life of the patients. In this quest, we reviewed the Hungarian and the international literature as well in context with otosclerosis, with special attention to the newest methods in diagnostics and treatment management. Orv Hetil. 2020; 161(19): 780-788.

摘要

耳硬化症是一种人类特有的耳部疾病,其特征是复杂的骨重塑,病因多因素。它影响骨迷路囊,进而使镫骨固定于卵圆窗缘。听骨链固定导致中耳声阻抗匹配和放大功能下降,从而导致传导性听力损失。该过程是渐进性的,当累及内耳结构时,也会使感音神经功能恶化。如果及时进行听力重建手术,疾病进程可以得到预防或延缓。镫骨手术的发展跨越了20世纪,尽管20世纪60年代由谢伊和马尔凯制定的主要手术步骤相当保守,但主要由于技术进步仍在进行微调。多项研究证实,镫骨切除术仍然是耳硬化症的首选治疗方案。采用适当的手术技术,可以使气导阈值显著改善,在言语频率范围内气骨导间距可最小化或消除,这显著提高了患者的生活质量。在这项研究中,我们结合耳硬化症回顾了匈牙利和国际文献,特别关注诊断和治疗管理的最新方法。《匈牙利医学周刊》。2020年;161(19): 780 - 788。

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