Soloperto Davide, Laura Elisa, Gazzini Luca, Cerullo Raffaele, Ferrulli Giuseppe, Nocini Riccardo, Molteni Gabriele, Marchioni Daniele
Division of Otolaryngology, Head and Neck Surgery Department, University Hospital of Verona, Piazzale L. A. Scuro 10, 37134, Verona, Italy.
Otolaryngology-Head and Neck Surgery Department, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
Eur Arch Otorhinolaryngol. 2023 Nov;280(11):4869-4878. doi: 10.1007/s00405-023-08005-w. Epub 2023 May 9.
To describe the surgical procedure of exclusive endoscopic ossiculoplasty (EEO) with autologous grafts and evaluate audiological results, focusing on the advantages or drawbacks compared to the corresponding microscopic technique.
A retrospective review of consecutive adult and pediatric patients affected by chronic otitis media (COM) with or without cholesteatoma who underwent EEO was conducted. Only autologous ossiculoplasty was included in the study. The procedure was performed by experienced surgeons of our institution between November 2014 and September 2019. Hearing outcomes were evaluated using postoperative air-bone gap (ABG) and success rates in different subgroups of patients and different types of ossiculoplasty (OPL) were analyzed. Our results were finally compared with the existing literature regarding both microscopic and endoscopic ossicular chain reconstruction.
In total, 74 endoscopic ossicular chain repair procedures performed within the study period met the inclusion criteria. Of these, 21 were pediatric patients (28%) and 53 were adults (72%). Surgical reconstruction procedures included 43 partial ossicular reconstructions (POR) and 31 total ossicular reconstructions (TOR). The postoperative ABG improved significantly compared to preoperative measurements, and the mean ABG closure was 7.85 dB HL (p = 0.00064). No statistically significant differences in audiological outcomes between TOR/POR techniques and pediatric/adult groups were found in our study cohort, with p values of 0.10 and 0.88, respectively.
At present, EEO can be considered a valid surgical option for re-establishing a functioning ossicular chain with acceptable hearing restoration in children and adults. Further reports in wider case series are required to confirm these results.
描述采用自体移植物的单纯内镜听骨链成形术（EEO）的手术过程，并评估听力结果，重点关注与相应显微镜技术相比的优缺点。
对连续接受EEO治疗的患有或不患有胆脂瘤的慢性中耳炎（COM）成年和儿科患者进行回顾性研究。本研究仅纳入自体听骨链成形术。该手术由本机构经验丰富的外科医生在2014年11月至2019年9月期间进行。使用术后气骨导差（ABG）评估听力结果，并分析不同患者亚组和不同类型听骨链成形术（OPL）的成功率。最后将我们的结果与有关显微镜和内镜听骨链重建的现有文献进行比较。
在研究期间共进行了74例内镜听骨链修复手术，均符合纳入标准。其中，21例为儿科患者（28%），53例为成人（72%）。手术重建程序包括43例部分听骨链重建（POR）和31例全听骨链重建（TOR）。与术前测量相比，术后ABG有显著改善，平均ABG闭合为7.85 dB HL（p = 0.00064）。在我们的研究队列中，TOR/POR技术与儿科/成人组之间在听力结果上未发现统计学显著差异，p值分别为0.10和0.88。
目前，EEO可被视为在儿童和成人中重建具有可接受听力恢复功能的听骨链的有效手术选择。需要更广泛病例系列的进一步报告来证实这些结果。
