Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Acta Otolaryngol. 2021 Jan;141(1):19-22. doi: 10.1080/00016489.2020.1815835. Epub 2020 Oct 16.
There are many reports on the role of the malleus handle in ossicular chain reconstruction (OCR). However, the effect of the presence of the malleus handle is not clear.
AIM/OBJECTIVES: To compare the hearing outcomes of using a partial ossicular replacement prosthesis (PORP) to reconstruct the ossicular chain under otoendoscopy with and without a malleus handle.
Records of 57 patients requiring OCR were retrospectively analyzed. They were divided into the malleus handle-present group (group 1) and the malleus handle-absent group (group 2). The audiometric results were analyzed pre- and postoperatively. A postoperative air-bone gap (ABG)≤20 dB was considered successful.
The mean improvement in air conduction hearing thresholds was 19.80 dB in group 1 and 16.70 dB in group 2. The mean ABG improvement was 18.09 ± 12.79 dB for group 1 and 17.20 ± 16.44 dB for group 2. The malleus handle-present group achieved higher success (65.63%) than the malleus handle-absent group (52%; > .05).
Improvements in hearing outcomes were similar for the two groups. However, the malleus handle-present group showed a better reconstruction success rate. Our results suggest that if there is no lesion in the malleus handle, it is recommended to be retained.
关于砧骨柄在听骨链重建（OCR）中的作用有很多报道。然而，砧骨柄存在的影响尚不清楚。
目的/目标：比较耳内镜下使用部分听骨赝复体（PORP）重建听骨链时保留和不保留砧骨柄的听力结果。
回顾性分析 57 例需要 OCR 的患者记录。他们被分为砧骨柄存在组（组 1）和砧骨柄缺失组（组 2）。分析术前和术后的听力结果。术后气骨导差（ABG）≤20dB 视为成功。
组 1 的气导听力阈值平均改善 19.80dB，组 2 为 16.70dB。组 1 的平均 ABG 改善为 18.09±12.79dB，组 2 为 17.20±16.44dB。砧骨柄存在组的成功率（65.63%）高于砧骨柄缺失组（52%；>.05）。
两组的听力结果改善相似。然而，砧骨柄存在组显示出更高的重建成功率。我们的结果表明，如果砧骨柄没有病变，建议保留。
