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 Sep-Oct;42(5):103062. doi: 10.1016/j.amjoto.2021.103062. Epub 2021 Apr 17.
The aim of our study was to perform a comparative analysis in our cases with titanium partial clip ossiculoplasty in terms of audiometric outcome and extrusion rates as well as to review the literature for relevant information on this surgical issue.
The records of all patients who had undergone primary partial ossiculoplasty with the implantation of a CliP® Partial Prosthesis Dresden Type (CPPDT, group A) or a CliP Partial FlexiBAL® (CPF, Group B, both Heinz Kurz GmbH, Dusslingen, Germany) between 2012 and 2020 were studied retrospectively.
274 patients made up our study sample (148 men, 126 women, male to female ratio: 1.17). Their mean age at the time of first surgery was 39.6 years (range: 4-79 years). The mean preoperative air-bone gap (ABG) was 22.7dΒ ± 10.5 dB. Mean follow-up was approximately 4 months (1-12 months). The mean postoperative ABG was 15.7 ± 8.1 dB. In total, the postoperative ABG was significantly improved compared to preoperative values (P < 0.001). Surgical success, defined as an ABG ≤ 20 dB, was achieved in the majority of our study patients (210/274, 76.6%). Extrusion of the prosthesis was detected in 3/216 CPF and 5/58 CPPDT cases (p = 0.012). Comparison of both prosthesis groups revealed a significantly better audiological outcome for the patients with ossicular reconstruction using CPF. A significantly better audiological outcome was detected in the cases with a normal aeration of the middle ear.
Titanium clip partial ossiculoplasty is a reliable component of modern tympanoplasty, allowing a satisfying audiologic outcome. The higher adaptability of the CPF to the changing postoperative circumstances and the frequently defective aeration of the middle ear is reflected in the better audiologic outcome for this prosthesis.
本研究旨在对我们使用钛夹部分听小骨成形术的病例进行比较分析，评估其听力结果和脱出率，并对这一手术问题的相关文献进行复习。
回顾性分析了 2012 年至 2020 年间接受 CliP® Partial Prosthesis Dresden Type（CPPDT，A 组）或 CliP Partial FlexiBAL®（CPF，B 组，均为 Heinz Kurz GmbH，德国杜塞尔多夫）植入的原发性部分听小骨成形术的所有患者的病历。
我们的研究样本包括 274 例患者（男性 148 例，女性 126 例，男女比例为 1.17）。他们初次手术时的平均年龄为 39.6 岁（范围：4-79 岁）。术前气骨导差（ABG）平均为 22.7dB±10.5dB。平均随访时间约为 4 个月（1-12 个月）。术后平均 ABG 为 15.7±8.1dB。与术前相比，术后 ABG 显著改善（P<0.001）。我们的大多数研究患者（210/274，76.6%）达到了手术成功的标准，即 ABG≤20dB。在 CPF 组中，有 3 例和 CPPDT 组中有 5 例（p=0.012）发现假体脱出。对两种假体组进行比较，发现使用 CPF 的患者在听力结果方面有显著改善。中耳通气正常的病例听力结果更好。
钛夹部分听小骨成形术是现代鼓室成形术的可靠组成部分，可获得令人满意的听力结果。CPF 对术后变化环境的适应性更强，中耳通气不良的情况更为常见，这反映在该假体的听力结果更好。
