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[联合听骨置换假体及Ⅲ型鼓室成形术全听骨置换假体的应用]

[Application of combined ossicular replacement prosthesis and total ossicular replacement prosthesis of type Ⅲ tympanoplasty].

作者信息

Wang Yajing, Chen Yuebo, Qiu Zeheng, Chen Suijun, Zhang Zhigang, Zheng Yiqing, Liang Maojin

机构信息

Department of Otolaryngology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510120,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 May;36(5):343-346. doi: 10.13201/j.issn.2096-7993.2022.05.004.

Abstract

This study investigated the application of combined ossicular replacement prosthesis(The Kurz Omega Connector+TORP) in type Ⅲ tympanoplasty, and compared the surgical effect with traditional TORP. Twenty patients with unilateral chronic suppurative otitis media diagnosed in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2019 to June 2020 were included in this study.All the patients were treated with intra-auricular incision with a microscopic approach(tympanic exploration, lesion clearance+type Ⅲ tympanoplasty). According to the placement of different types of ossicular replacement prosthesis in the ossicular chain reconstruction of type Ⅲ tympanoplasty, the patients were divided into two groups: the traditional TORP group(=10) and the combined ossicular replacement prosthesis(The Kurz Omega Connector+TORP) group(=10). All patients underwent pure tone audiometry before and 1 year after the operation, and the average hearing threshold and air-bone conduction difference(ABG) were compared between the two groups before and after the operation. The reconstruction of the ossicular chain was completed successfully in all patients. Endoscopic examination showed that the epithelialization of the operative cavity was good and the repair of the tympanic membrane recovered well one month after the operation. There was no significant difference in preoperative mean airway threshold between the combined ossicular replacement prosthesis and the traditional TORP group (74.13[41.50,80.50] dB vs 74.25[44.81,82.50] dB, >0.05), there was no significant difference in preoperative ABG (55.63[21.50,61.25] dB vs 54.13[23.63,60.38] dB, >0.05). After the operation, the ABG of the combined auriculus group was significantly lower than that of the traditional operation group (12.00[5.75,24.56] dB vs 34.88[14.19,46.44] dB, <0.05). Conclusion: The combined ossicular replacement prosthesis(The Kurz Omega Connector+TORP) can increase the stability of hearing reconstruction and improve hearing in type Ⅲ tympanoplasty.

摘要

本研究探讨了联合听骨置换假体(Kurz Omega连接器+全听骨赝复物)在Ⅲ型鼓室成形术中的应用,并将其手术效果与传统全听骨赝复物进行比较。纳入2019年1月至2020年6月在中山大学孙逸仙纪念医院耳鼻咽喉科诊断为单侧慢性化脓性中耳炎的20例患者。所有患者均采用耳内切口显微镜下手术(鼓膜探查、病变清除+Ⅲ型鼓室成形术)。根据Ⅲ型鼓室成形术听骨链重建中不同类型听骨置换假体的置入情况,将患者分为两组:传统全听骨赝复物组(n=10)和联合听骨置换假体(Kurz Omega连接器+全听骨赝复物)组(n=10)。所有患者在术前及术后1年进行纯音听力测试,比较两组手术前后的平均听阈和气骨导差(ABG)。所有患者听骨链重建均成功完成。术后1个月内镜检查显示术腔上皮化良好,鼓膜修复恢复良好。联合听骨置换假体组与传统全听骨赝复物组术前平均气导阈值差异无统计学意义(74.13[41.50,80.50]dB比74.25[44.81,82.50]dB,P>0.05);术前ABG差异无统计学意义(55.63[21.50,61.25]dB比54.13[23.63,60.38]dB,P>0.05)。术后联合听骨置换假体组ABG明显低于传统手术组(12.00[5.75,24.56]dB比34.88[14.19,46.44]dB,P<0.05)。结论:联合听骨置换假体(Kurz Omega连接器+全听骨赝复物)可提高Ⅲ型鼓室成形术听力重建的稳定性并改善听力。

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本文引用的文献

1
[Postoperative hearing in tympanoplasty preserving the manubrium of malleus and tensor tympani muscle tendon].[保留锤骨柄和鼓膜张肌腱的鼓室成形术后听力]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov;35(11):981-987. doi: 10.13201/j.issn.2096-7993.2021.11.005.
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[Recent and long-term hearing outcomes in the cases after open tympanoplasty using titanium ossicular prosthesis].
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Nov;30(22):1803-1805. doi: 10.13201/j.issn.1001-1781.2016.22.015.
8
Stabilization of total ossicular replacement prosthesis using cartilage "shoe" graft.
Am J Otolaryngol. 2016 Mar-Apr;37(2):74-7. doi: 10.1016/j.amjoto.2015.12.001. Epub 2015 Dec 8.
10
Total ossiculoplasty: advantages of two-point stabilization technique.全听骨成形术:两点稳定技术的优势
Int J Otolaryngol. 2012;2012:346260. doi: 10.1155/2012/346260. Epub 2012 Aug 16.

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