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内镜下一期镫骨切除术中不同材料镫骨假体骨水泥固定的比较

Comparison of Bone Cement Fixation for Stapes Prostheses with Different Materials in Endoscopic Primary Stapedectomy.

作者信息

Hamead Khalaf, Talaat Mostafa, Hafez Montasser AbdelSalam, Gamal Reham, elAziz Ahmed AbdelRahman Abd, Abdelaal Abdelhady Omnia, Abdelmoneim Rasha Ahmed, Hamad AbdelMoneim H

机构信息

Department of Otorhinolaryngology, Faculty of Medicine, Minia University, Minia, Egypt.

Audiology unit, Department of Otorhinolaryngology, Faculty of Medicine, Minia University, Minia, Egypt.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3353-3363. doi: 10.1007/s12070-024-04687-8. Epub 2024 Apr 29.

Abstract

Otosclerosis is a complex skeletal condition that originates from both hereditary and environmental factors. Gradual conductive hearing loss is the main character. Aim to contrast and assess the postoperative results, such as hearing improvement, following the use of bone cement to fix the Titanium versus Teflon stapes piston. 50 patients who had endoscopic stapedotomy with different prostheses insertions were included in this prospective, randomized research. They were splitted into two groups in the: group A consisted of 25 ears in which titanium prostheses with bone cement were applied, while group B consisted of 25 ears Teflon prostheses with bone cement were used. A statistically significant difference was observed in average air conduction (better hearing) between groups A and B at 3, 6, and 12 months postoperatively based on audiometric results. When comparing groups B and A after 3, 6, and 12 months after surgery, the average air bone gap (ABG) was greater in group B, and this difference was statistically significant. Between the two groups, there was no discernible variation in any of the preoperative metrics. 96% of groups A and B were successful. Using bone cement in primary stapedotomy may help fix the procedure and reduce the chance of persistent hearing loss in patients with otosclerosis. This is especially true when titanium is used, as titanium has the ideal mass and stiffness to support acoustic transmission with a low rate of adverse effects and better average ABG.

摘要

耳硬化症是一种复杂的骨骼疾病,其发病源于遗传和环境因素。渐进性传导性听力损失是其主要特征。旨在对比和评估使用骨水泥固定钛质与聚四氟乙烯镫骨活塞后的术后结果,如听力改善情况。这项前瞻性随机研究纳入了50例行内镜下镫骨切除术并植入不同假体的患者。他们被分为两组:A组有25只耳朵,应用了带骨水泥的钛质假体,而B组有25只耳朵,使用了带骨水泥的聚四氟乙烯假体。根据听力测试结果,术后3个月、6个月和12个月时,A组和B组之间的平均气导(听力更好)存在统计学显著差异。术后3个月、6个月和12个月比较B组和A组时,B组的平均气骨间隙(ABG)更大,且这种差异具有统计学意义。两组术前各项指标均无明显差异。A组和B组的成功率均为96%。在初次镫骨切除术中使用骨水泥可能有助于固定手术并降低耳硬化症患者持续性听力损失的几率。使用钛质假体时尤其如此,因为钛具有理想的质量和硬度,可支持声音传导,不良反应发生率低且平均ABG更好。

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本文引用的文献

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