ENT Department, L. Vanvitelli University, Naples, Italy.
ENT Department, "S. Maria delle Grazie" Hospital, Pozzuoli, Naples), Italy.
Ear Nose Throat J. 2023 Sep;102(9):611-615. doi: 10.1177/01455613211013093. Epub 2021 May 11.
Surgical treatment of patients with far-advanced otosclerosis (FAO) has not yet been standardized. Patients with FAO are the candidates for stapes surgery or cochlear implant (CI). Although many surgeons consider stapes surgery as the first choice, other authors prefer CI because of the excellent hearing results.
The authors discuss their experience in the treatment of patients with FAO, potentially candidates for CI, who underwent stapedotomy.
Eleven adult patients with FAO underwent stapedotomy from 2006 to 2016. Pure-tone average (PTA) between 0.5-1-2-3 kHz and speech perception test with hearing aids were determined before and after stapedotomy.
The results show a statistically significant improvement in air condition threshold (PTA) and satisfactory results with regard to speech recognition in 9 (81.8%) cases. Postoperative results are not influenced by the type of stapedotomy prosthesis employed and do not change during follow-up (3 years).
The authors suggest first performing stapes surgery in patients with FAO and reserving CI in case of failure.
对于晚期耳硬化症(FAO)患者的手术治疗尚未标准化。FAO 患者是镫骨手术或人工耳蜗植入(CI)的候选者。尽管许多外科医生认为镫骨手术是首选,但其他作者更喜欢 CI,因为其听力效果极佳。
作者讨论了他们在治疗潜在 CI 候选者 FAO 患者方面的经验,这些患者接受了镫骨切开术。
2006 年至 2016 年间,11 名 FAO 成年患者接受了镫骨切开术。在镫骨切开术前和术后,测定纯音平均(PTA)在 0.5-1-2-3 kHz 之间以及使用助听器的言语感知测试。
结果显示,空气条件阈值(PTA)有统计学意义的改善,9 例(81.8%)患者的言语识别有令人满意的结果。术后结果不受所使用的镫骨切开术假体类型的影响,并且在随访(3 年)期间不会改变。
作者建议在 FAO 患者中首先进行镫骨手术,并在手术失败的情况下保留 CI。