Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany.
Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany.
Am J Otolaryngol. 2021 Jul-Aug;42(4):103002. doi: 10.1016/j.amjoto.2021.103002. Epub 2021 Mar 22.
Erosion of the long process of the incus is the most common ossicular chain pathology occurring in the course of chronic middle ear disease. The aim of this study was to evaluate our experience in the reconstruction of short-length defects of the long process of the incus using hydroxyapatite bone cement over a period of 15 years.
The medical records of all patients treated with hydroxyapatite bone cement for an isolated short-length erosion of the long process of the incus or the lenticular process at an academic tertiary referral center between 2005 and 2019 were studied retrospectively.
48 patients made up our study sample (19 men, 29 women). The mean age at the time of surgery was 38.1 years. The mean preoperative air-bone gap (ABG) was 21.36 dB. The mean postoperative ABG was 15.89 dB within 8 weeks of surgery and 11.81 dB at least 6 months after surgery. The postoperative ABG had significantly improved compared to preoperative ABG values at both the short- and middle-term follow-up (p < 0.001 for both). An ABG ≤ 20 dB was achieved in 68% in the short term and 83% in the middle term. The mean ABG in the long term (< 12 months) was 11.1 dB.
Restoration of the anatomic and functional continuity of the ossicular chain using hydroxyapatite cement in defects of the long process of the incus seems to warrant a satisfactory audiologic outcome in the majority of cases.
砧骨长突的侵蚀是慢性中耳疾病过程中最常见的听骨链病变。本研究旨在评估我们在过去 15 年中使用羟基磷灰石骨水泥重建砧骨长突短缩缺损的经验。
回顾性研究了 2005 年至 2019 年在一家学术性三级转诊中心，使用羟基磷灰石骨水泥治疗孤立性砧骨长突或豆状突短缩侵蚀的所有患者的病历。
48 例患者构成了我们的研究样本（19 名男性，29 名女性）。手术时的平均年龄为 38.1 岁。术前气骨导差（ABG）平均为 21.36dB。术后 8 周内平均 ABG 为 15.89dB，术后至少 6 个月时平均 ABG 为 11.81dB。与术前 ABG 值相比，短期和中期随访的术后 ABG 均有显著改善（两者均 p<0.001）。短期随访时，68%的患者 ABG≤20dB，中期随访时，83%的患者 ABG≤20dB。长期（<12 个月）ABG 平均为 11.1dB。
使用羟基磷灰石水泥修复砧骨长突缺损，重建听骨链的解剖和功能连续性，在大多数情况下似乎可以获得满意的听力结果。
