Bouhafs Khalid, Lachkar Azeddine, Benallal Abderrahim, Benfadil Drissia, Ghailan Mohammed Rachid
Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Mohammed VI d'Oujda, Oujda, Maroc.
Pan Afr Med J. 2021 Feb 18;38:187. doi: 10.11604/pamj.2021.38.187.27449. eCollection 2021.
The purpose of this study was to evaluate the functional outcomes of ossiculoplasties. We conducted a retrospective study, in the department of ear, nose and throat (ENT) and congestive cardiac failure (CCF) at the University Hospital Mohammed VI, in Oujda, from October 2018 to March 2020. Out of 45 patients with secondary otitis, 30 had gone ossiculoplasty using endoscopic transmeatal approach. These patients were enrolled in the study. The average age of patients was 31.8 years, with a F/M sex ratio of 1.5. The examination of the eardrum showed type A otitis (18 cases) type B otitis (5 cases), type C otitis (3 cases) and type D otitis (4 cases), according to Austin classification; 70% of patients who had undergone surgery had hearing loss between 30 and 40 dB and 30% of patients had hearing loss of ≥40 dB. Type II ossiculoplasty was performed in 26 cases, using tragal cartilage in 18 cases. Autologous incus interposition graft and placement of titanium PORP were performed in 4 cases each, whereas ossiculoplasty type III was performed in 4 cases, with placement of titanium TORP. Type II ossiculoplasty group had a hearing gain of ≥20 dB (all cases), whereas type III ossiculoplasty group had a hearing gain of ≥1 dB (1 case). Success rate was 90%. The analysis of these results shows that the overall outcome is slightly worse in patients undergoing type III ossiculoplasty than in those undergoing type II ossiculoplasty. However, comparative studies between the placement of prostheses and autografts or between different types of materials have only shown minor differences reported by the same author or the same team. Many authors highlighted that the preservation of the handle of malleus could provide better functional results.
本研究的目的是评估鼓室成形术的功能结果。我们于2018年10月至2020年3月在乌季达的穆罕默德六世大学医院耳鼻喉科和充血性心力衰竭科进行了一项回顾性研究。在45例继发性中耳炎患者中,30例采用内镜经耳道入路进行了鼓室成形术。这些患者被纳入研究。患者的平均年龄为31.8岁,男女比例为1.5。根据奥斯汀分类法,鼓膜检查显示A型中耳炎(18例)、B型中耳炎(5例)、C型中耳炎(3例)和D型中耳炎(4例);接受手术的患者中,70%的听力损失在30至40分贝之间,30%的患者听力损失≥40分贝。26例患者进行了II型鼓室成形术,其中18例使用了耳屏软骨。4例患者分别进行了自体砧骨植入移植和钛质PORP植入,4例患者进行了III型鼓室成形术并植入了钛质TORP。II型鼓室成形术组听力增益≥20分贝(所有病例),而III型鼓室成形术组听力增益≥1分贝(1例)。成功率为90%。对这些结果的分析表明,接受III型鼓室成形术的患者的总体结果略逊于接受II型鼓室成形术的患者。然而,假体植入与自体移植之间或不同类型材料之间的比较研究仅显示同一作者或同一团队报告的微小差异。许多作者强调,保留锤骨柄可提供更好的功能结果。