Roychowdhury Prithwijit, Polanik Marc D, Kempfle Judith S, Castillo-Bustamante Melissa, Fikucki Cheryl, Wang Michael J, Kozin Elliott D, Remenschneider Aaron K
Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.
Department of Otolaryngology University of Massachusetts Medical School Worcester Massachusetts USA.
Laryngoscope Investig Otolaryngol. 2021 Jun 11;6(4):824-831. doi: 10.1002/lio2.599. eCollection 2021 Aug.
Stapedotomy is performed to address conductive hearing deficits. While hearing thresholds reliably improve at low frequencies (LF), conductive outcomes at high frequencies (HF) are less reliable and have not been well described. Herein, we evaluate post-operative HF air-bone gap (ABG) changes and measure HF air conduction (AC) thresholds changes as a function of frequency.
Retrospective review of patients who underwent primary stapedotomy with incus wire piston prosthesis between January 2016 and May 2020. Pre- and postoperative audiograms were evaluated. LF ABG was calculated as the mean ABG of thresholds at 250, 500, and 1000 Hz. HF ABG was calculated at 4 kHz.
Forty-six cases met criteria. Mean age at surgery was 54.0 ± 11.7 years. The LF mean preoperative ABG was 36.9 ± 11.0 dB and postoperatively this significantly reduced to 9.35 ± 6.76 dB, ( < .001). The HF mean preoperative ABG was 31.1 ± 14.4 dB and postoperatively, this also significantly reduced to 14.5 ± 12.3 dB, ( < .001). The magnitude of LF ABG closure was over 1.5 times the magnitude of HF ABG closure ( < .001). The gain in AC decreased with increasing frequency ( < .001).
Hearing improvement following stapedotomy is greater at low than high frequencies. Postoperative air bone gaps persist at 4 kHz. Further biomechanical and histopathologic work is necessary to localize postoperative high frequency conductive hearing deficits and improve stapedotomy hearing outcomes.
4, retrospective study.
镫骨切除术用于解决传导性听力缺陷问题。虽然低频（LF）听力阈值确实能可靠改善，但高频（HF）的传导性结果不太可靠且尚未得到充分描述。在此，我们评估术后高频气骨导间距（ABG）的变化，并测量高频气导（AC）阈值随频率的变化。
回顾性分析2016年1月至2020年5月期间接受初次镫骨切除术并植入砧骨钢丝活塞假体的患者。评估术前和术后的听力图。低频ABG计算为250、500和1000Hz阈值的平均ABG。高频ABG在4kHz计算。
46例符合标准。手术时的平均年龄为54.0±11.7岁。术前低频平均ABG为36.9±11.0dB，术后显著降至9.35±6.76dB，（<0.001）。术前高频平均ABG为31.1±14.4dB，术后也显著降至14.5±12.3dB，（<0.001）。低频ABG闭合幅度是高频ABG闭合幅度的1.5倍以上（<0.001）。AC增益随频率增加而降低（<0.001）。
镫骨切除术后低频听力改善大于高频。术后4kHz气骨导间距仍然存在。需要进一步的生物力学和组织病理学研究来定位术后高频传导性听力缺陷并改善镫骨切除术的听力结果。
4级，回顾性研究。
