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骨桥植入联合同期双侧耳廓再造治疗双侧先天性外耳道闭锁

[Bonebridge implantation combined with simultaneous bilateral auricle reconstruction for bilateral congenital aural atresia].

作者信息

Wang D N, Wang B Q, Wang Y, Ren R, Chen P W, Yang J S, Zhao C L, Zhang Q G, Zhao S Q

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Beijing Institute of Otolaryngology, Beijing 100005, China.

Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Apr 7;56(4):340-345. doi: 10.3760/cma.j.cn115330-20200425-00327.

Abstract

To investigate the feasibility and safety of auricle reconstruction combined with Bonebridge implantation for bilateral aural atresia patients. A retrospective analysis was conducted for 36 cases(72 ears) who underwent Bonebridge implantation combined with bilateral auricle reconstruction from February 1, 2017 to January 15, 2020. All cases were bilateral congenital aural atresia and underwent Nagata auricle reconstruction for both sides simultaneously. Bonebridge implantations were performed during the second stage of auricle reconstruction. All 36 patients healed well and had no surgical complications when discharged. The preoperative average bone conduction threshold of the patients was(8.5±5.8) dB HL and postoperative bone conduction threshold was (8.4±5.2) dB HL. There was no significant change after the implantation (=0.724). The preoperative average air conduction threshold of was(64.9±7.4)dB HL and postoperative air conduction threshold was (24.0±5.3) dB HL, which had a significant change after the implantation (<0.001). The hearing threshold with Bonebridge significantly decreased by 40.9 dB HL compared with the preoperative air conduction threshold(<0.001). The speech recognition rate of monosyllable words, disyllabic words and short sentences in quiet environment increased by 62.5%, 63.5% and 72.2% respectively. The differences were statistically significant (<0.001). The speech recognition rate of monosyllabic words, disyllabic words and short sentences in noise environment were significantly increased by 55.9%, 58.9% and 69.9% respectively (<0.001). After a follow-up of 18.3 months in average, the hearing results were stable and the aesthetic outcomes were satisfied. One patient had implant rupture and healed after revision surgery. With an integrated surgical procedure, patients with bilateral congenital aural atresia can complete bilateral auricle reconstruction and hearing implantation within six months. This integrated surgical procedure is safe and efficient, with a stable hearing improvement and good appearance.

摘要

探讨双侧外耳道闭锁患者同期行耳廓再造联合骨桥植入的可行性及安全性。对2017年2月1日至2020年1月15日期间36例(72耳)接受骨桥植入联合双侧耳廓再造术的患者进行回顾性分析。所有病例均为双侧先天性外耳道闭锁,同期行双侧Nagata法耳廓再造术,骨桥植入于耳廓再造二期进行。36例患者术后愈合良好,出院时均无手术并发症。患者术前平均骨导阈值为(8.5±5.8)dB HL,术后骨导阈值为(8.4±5.2)dB HL,植入后差异无统计学意义(=0.724)。术前平均气导阈值为(64.9±7.4)dB HL,术后气导阈值为(24.0±5.3)dB HL,植入后差异有统计学意义(<0.001)。骨桥植入后听力阈值较术前气导阈值显著下降40.9 dB HL(<0.001)。安静环境下单音节词、双音节词及短句的言语识别率分别提高62.5%、63.5%及72.2%,差异有统计学意义(<0.001)。噪声环境下单音节词、双音节词及短句的言语识别率分别显著提高55.9%、

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