Hammoud Rani, Larem Aisha, Emam Fatima, Al-Qudimat Ahmad R, Aljariri Adham, Alqahtani Abdulsalam, Elderee Aya, Al Saadi Ali, Elhakeem Amr, Abdulkarim Hassanin, Haidar Hassan
Department of Otolaryngology - Head and Neck Surgery, Hamad Medical Corporation, Doha, QAT.
Department of Radiology, Hamad Medical Corporation, Doha, QAT.
Cureus. 2024 Jul 18;16(7):e64802. doi: 10.7759/cureus.64802. eCollection 2024 Jul.
Background Stapes surgery success depends on several factors, including the length of the prosthesis used. Whether to use a standard-size prosthesis or measure the length of the stapes prosthesis has been debated in the literature. This study aims to assess the surgical outcomes of a stapedotomy using the standard 4.5 mm prosthesis without custom measurements. Methodology This retrospective study involved patients with otosclerosis who underwent primary stapedotomy using a standardized 4.5 mm fixed-length prosthesis between January 2017 and February 2023 at a tertiary care center. Results Out of 111 charts reviewed, 99 ears (56 males and 43 females) were studied. The mean air-bone gap (ABG) significantly improved from 27.9 ± 9.12 dB preoperatively to 3.95 ± 3.54 dB post-operatively (p-value < 0.05). Hearing results showed that out of 99 ears, 96.96% had a postoperative ABG of ≤10 dB and 98.98% ≤20 dB. Only three patients showed postoperative mild transient dizziness that lasted a few days. None of the patients had persistent dizziness for more than one week. One patient developed postoperative reparative granuloma with tinnitus and sensory-neural hearing loss. None had a recurrence of the conductive hearing loss during the study period. Conclusion Our retrospective study on stapes surgery utilizing a standardized 4.5 mm prosthesis without custom measurements showed notable surgical success and safety. Using a standard-size prosthesis shortens the surgical time and eliminates the complexities associated with intraoperative measurements, potentially reducing the risk of complications.
背景 镫骨手术的成功取决于多个因素，包括所使用假体的长度。文献中对于是使用标准尺寸的假体还是测量镫骨假体的长度一直存在争议。本研究旨在评估使用标准4.5毫米假体而非定制测量进行镫骨切除术的手术效果。方法 这项回顾性研究纳入了2017年1月至2023年2月期间在一家三级医疗中心接受使用标准化4.5毫米固定长度假体进行初次镫骨切除术的耳硬化症患者。结果 在审查的111份病历中，研究了99只耳朵（56名男性和43名女性）。平均气骨导间距（ABG）从术前的27.9±9.12分贝显著改善至术后的3.95±3.54分贝（p值<0.05）。听力结果显示，在99只耳朵中，96.96%的术后ABG≤10分贝，98.98%≤20分贝。只有三名患者术后出现轻度短暂头晕，持续了几天。没有患者出现持续超过一周的头晕。一名患者术后出现修复性肉芽肿并伴有耳鸣和感音神经性听力损失。在研究期间，没有人出现传导性听力损失复发。结论 我们对使用标准化4.5毫米假体而非定制测量进行镫骨手术的回顾性研究显示出显著的手术成功率和安全性。使用标准尺寸的假体缩短了手术时间，消除了与术中测量相关的复杂性，有可能降低并发症风险。
