ENT Department, University of Turin, Turin, Italy.
Acta Otolaryngol. 2020 Sep;140(9):745-748. doi: 10.1080/00016489.2020.1764618. Epub 2020 May 20.
In otosclerosis mixed hearing loss is the most frequent symptom and arises when the focus involves the stapes footplate. Surgeons usually prefer to wait a minimum air-bone gap of 25 - 35 dB before surgery. To evaluate the outcome of microdrill stapedotomy for otosclerosis in patients with a preoperative air-bone gap (ABG) <25 dB versus patients with a preoperative gap ≥ 25 dB. For this retrospective study, the outcomes and complications after microdrill stapedotomy were compared between adult patients with a preoperative small ABG ( = 127, ABG <25 dB) and those with a large ABG ( = 254, ABG ≥25 dB). The postoperative ABG was significantly smaller than the preoperative ABG ( < .05) in both groups; there were no differences in complications rates (severe sensorineural hearing loss, footplate fracture or early postoperative vertigo) between the two groups. Our findings show that microdrill stapedotomy is safe and can be performed even in patients with a preoperative small ABG without increasing the risk of sensorineural hearing loss due to inner ear damage.
在耳硬化症中，混合性听力损失是最常见的症状，当焦点涉及镫骨底板时就会出现。外科医生通常更喜欢在手术前等待至少 25-35dB 的气骨间隙。评估术前气骨间隙（ABG）<25dB 的耳硬化症患者与术前间隙≥25dB 的患者接受微钻镫骨切开术的结果。为了进行这项回顾性研究，将术前 ABG 较小（n=127，ABG<25dB）和较大（n=254，ABG≥25dB）的成年患者微钻镫骨切开术后的结果和并发症进行了比较。两组患者术后 ABG 均明显小于术前 ABG（<0.05）；两组并发症发生率（严重感音神经性听力损失、底板骨折或术后早期眩晕）无差异。我们的研究结果表明，即使在术前 ABG 较小的患者中，微钻镫骨切开术也是安全的，并且不会因内耳损伤而增加感音神经性听力损失的风险。
