Xie Li, Liu Aiguo, Shenoy Imrit T, Peng Liyan, Zhou Liangqiang
Department of Otolaryngology Head and Neck Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430030,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Dec;34(12):1074-1078. doi: 10.13201/j.issn.2096-7993.2020.12.005.
To assess the short-term efficacy of laser-assisted stapedotomy in patients with otosclerosis. The clinical data of twenty-one patients with otosclerosis who underwent laser-assisted stapedotomy were retrospectively analyzed . Preoperative and 3-month postoperative standardized audiometric evaluations were carried out in all patients. The occurrence of surgical complications was observed. The mean preoperative and postoperative air conduction (AC) thresholds were (58.2±12.7) dB HL and (43.0±23.1)dB HL respectively; the postoperative AC threshold decreased by 15.2 dB HL which was statistically significant at 0.5, 1, 2, and 4 kHz (<0.01). The mean preoperative and postoperative bone conduction (BC) thresholds were (31.4±10.3)dB HL and (33.3±16.6)dB HL, and there was not significant difference between them as well as BC thresholds at each frequency. Overclosure >10 dB HL was occured in 3 ears (14.3%) while sensorineural hearing loss>10 dB HL was found in 2 ears (9.5%). The mean ABG decreased by 17.4 dB HL (<0.01) from preoperative (27.0±9.1) dB HL to postoperative (9.6±9.9) dB HL, and the ABG at each frequency had significant decrease. Fourteen ears (66.7%) had postoperative ABG of ≤10 dB HL while 18 ears (85.7%) had postoperative ABG of ≤20 dB HL. Sensorineural hearing loss occurred in 2 ears (9.5%) after surgery, tinnitus in 15 ears (71.4%) and vertigo in 3 ears (14.3%). But all were relieved on the third day after operation. Laser-assisted stapedotomy is a safe and effective treatment of otosclerosis. Although BC thresholds was slightly increased after surgery, it did not affect the overall hearing outcomes.
评估激光镫骨切除术治疗耳硬化症患者的短期疗效。回顾性分析21例行激光镫骨切除术的耳硬化症患者的临床资料。对所有患者进行术前及术后3个月的标准化听力评估,并观察手术并发症的发生情况。术前和术后平均气导(AC)阈值分别为(58.2±12.7)dB HL和(43.0±23.1)dB HL;术后AC阈值下降了15.2 dB HL,在0.5、1、2和4 kHz频率处差异有统计学意义(<0.01)。术前和术后平均骨导(BC)阈值分别为(31.4±10.3)dB HL和(33.3±16.6)dB HL,两者之间以及各频率的BC阈值均无显著差异。3耳(14.3%)出现超闭合>10 dB HL,2耳(9.5%)出现感音神经性听力损失>10 dB HL。平均气骨导差(ABG)从术前的(27.0±9.1)dB HL降至术后的(9.6±9.9)dB HL,下降了17.4 dB HL(<0.01),各频率的ABG均有显著下降。14耳(66.7%)术后ABG≤10 dB HL,18耳(85.7%)术后ABG≤20 dB HL。术后2耳(9.5%)出现感音神经性听力损失,15耳(71.4%)出现耳鸣,3耳(14.3%)出现眩晕,但均在术后第3天缓解。激光镫骨切除术是治疗耳硬化症的一种安全有效的方法。虽然术后BC阈值略有升高,但不影响整体听力结果。