Service ORL et chirurgie cervicofaciale du CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France; Faculté de médecine de l'université de Tours, boulevard Tonnellé, 37000 Tours, France.
Service ORL et chirurgie cervicofaciale du CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Oct;138(5):349-353. doi: 10.1016/j.anorl.2021.03.001. Epub 2021 Mar 23.
The main study endpoint was tolerance of stapedotomy under local anesthesia with sedation and under general anesthesia using stress and quality of life assessment questionnaires. Secondary endpoints comprised operative time and functional results.
In a consecutive series of stapedotomy patients operated on over a 12-month period, quality of life and perioperative stress were analysed by 3 questionnaires: the Glasgow Benefit Inventory, Cohen's perceived stress scale and the Post-traumatic stress disorder checklist scale. Questionnaire responses and audiometric data were compared between groups treated under local anesthesia with sedation and under general anesthesia.
Twenty-two patients were included in the local anesthesia with sedation group and 6 in the general anesthesia group. There was no difference between the groups for quality of life, onset of post-traumatic stress, or perceived pre- and postoperative stress. There was also no difference in operative time. The audiometric data confirmed the reliability of stapedotomy. Stapedotomy under local anesthesia with sedation improved air conduction with≤10dB air-bone gap (ABG), comparable to results under general anesthesia. The rate of ABG≤10dB was 71.4%; no labyrinthisation was observed.
Under local anesthesia with sedation, stapedotomy was well tolerated without increasing the stress associated with otosclerosis surgery. By correcting hearing loss, the procedure improves quality of life.
主要研究终点是通过使用应激和生活质量评估问卷,在局部麻醉镇静和全身麻醉下,对镫骨切开术的耐受性进行评估。次要终点包括手术时间和功能结果。
在一项连续的镫骨切开术患者系列研究中,在 12 个月的时间内,通过 3 个问卷分析生活质量和围手术期应激:格拉斯哥获益量表、科恩感知应激量表和创伤后应激障碍清单量表。对在局部麻醉镇静和全身麻醉下治疗的两组患者的问卷反应和听力数据进行比较。
22 例患者纳入局部麻醉镇静组,6 例患者纳入全身麻醉组。两组患者在生活质量、创伤后应激的发生、术前和术后感知应激方面均无差异。手术时间也无差异。听力数据证实了镫骨切开术的可靠性。局部麻醉镇静下的镫骨切开术可改善气导,气骨导差≤10dB,与全身麻醉结果相当。气骨导差≤10dB 的比例为 71.4%;未观察到迷路化。
在局部麻醉镇静下,镫骨切开术耐受性良好,不会增加与耳硬化症手术相关的应激。通过纠正听力损失,该手术可提高生活质量。