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微钻与二极管激光在内镜镫骨切开术中的比较研究。

Microdrill Versus Diode Laser in Endoscopic Stapedotomy: A Comparative Study.

机构信息

ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University and Key Laboratory of Hearing Medicine of National Health and Family Planning Commission (NHFPC), Shanghai 200031, China.

Department of otolaryngology, Taizhou Central Hospital, Taizhou 318000, China.

出版信息

Otol Neurotol. 2024 Jun 1;45(5):489-494. doi: 10.1097/MAO.0000000000004177. Epub 2024 Mar 26.

Abstract

BACKGROUND

Microdrill and diode laser are two different methods used in endoscopic stapedotomy for otosclerosis. These two methods have not been compared in endoscopic stapedotomy.

AIMS/OBJECTIVES: To analyze the differences between microdrill and diode laser in endoscopic stapedotomy for otosclerosis.

MATERIALS AND METHODS

This is a randomized clinical trial; patients with otosclerosis were randomly divided into microdrill group (group A: n = 69) and diode laser group (group B: n = 62). Differences between the two groups were then compared.

RESULTS

The preoperative air-bone gap (ABG) was 25.40 ± 10.88 dBHL in group A and 24.84 ± 12.23 dBHL in group B, with no significant between-group difference ( p > 0.05). The postoperative ABG in group A was 13.27 ± 9.91 dBHL versus 11.79 ± 10.82 dBHL in group B, and there was no significant difference between the groups ( p > 0.05). The surgical time in group B (64 ± 31.23 minutes) was significantly longer than that in group A (48 ± 25.62 minutes) ( p = 0.02). There were no significant between-group differences in basic patient-related data, preoperative air conduction (AC), preoperative bone conduction (BC), postoperative AC, distribution of postoperative ABG, preoperative ABG at different frequencies, and postoperative ABG at different frequencies. There was also no significant between-group difference in the average bleeding volume or number of patients with postoperative dizziness.

CONCLUSION AND SIGNIFICANCE

The postoperative improvement in hearing level in the two group was equivalent, but group A had the advantage of a shorter operation time.

LEVEL OF EVIDENCE

摘要

背景

耳内镜镫骨切除术治疗耳硬化症中,微钻和二极管激光是两种不同的方法。这两种方法在耳内镜镫骨切除术方面尚未进行比较。

目的

分析耳内镜镫骨切除术治疗耳硬化症中微钻和二极管激光的差异。

材料和方法

这是一项随机临床试验;将耳硬化症患者随机分为微钻组(A 组:n = 69)和二极管激光组(B 组:n = 62),然后比较两组之间的差异。

结果

A 组术前气骨导差(ABG)为 25.40 ± 10.88dBHL,B 组为 24.84 ± 12.23dBHL,两组间无显著差异(p>0.05)。A 组术后 ABG 为 13.27 ± 9.91dBHL,B 组为 11.79 ± 10.82dBHL,两组间无显著差异(p>0.05)。B 组的手术时间(64 ± 31.23 分钟)明显长于 A 组(48 ± 25.62 分钟)(p = 0.02)。两组间基本患者相关数据、术前气导(AC)、术前骨导(BC)、术后 AC、术后 ABG 分布、术前不同频率 ABG、术后不同频率 ABG 无显著差异。两组平均出血量或术后头晕患者数也无显著差异。

结论及意义

两组术后听力水平改善相当,但 A 组手术时间更短。

证据等级

4 级。

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