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[分析58例耳硬化症及听骨链畸形患者行光纤激光镫骨开窗术的疗效]

[Analysis of the efficacy of fiber laser stapes fenestration in the treatment of 58 cases of otosclerosis and ossicular malformation].

作者信息

Zhang Y N, Qiu S J, Cao B, Wei Z Y, Shen Z S

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo 315040, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Aug 7;59(8):797-802. doi: 10.3760/cma.j.cn115330-20231215-00296.

Abstract

To explore the surgical efficacy of conductive deafness caused by otosclerosis and ossicular malformation with 980 nm fiber laser stapedial floor fenestration. Data of 58 patients (ears) who were diagnosed with conductive deafness caused by otosclerosis (49 ears) and ossicular malformation (9 ears) treated by 980 nm Diode laser small-fenestra stapedotomy were retrospectively analyzed. Air conduction (AC) thresholds, bone conduction (BC) thresholds, and air-bone gap (ABG) at 0.5, 1, 2, 4 kHz pure tone frequencies were compared before and 3 months after surgery, and the advantages and precautions of 980 nm fiber laser were summarized. Paired -test (SPSS 26.0 software) was use to analyze the listening data. Fiber optic laser stapes fenestration and artificial stapes implantation were successfully completed in all 57 cases (ears), the hearing of another one patient (ear) with floating malformation of detachment of stapedial floor was lower than that before surgery. Preoperative at 0.5, 1, 2, 4 kHz frequencies of AC thresholds, BC thresholds, and ABG were (65.4±9.7) dB, (27.2±8.9) dB, and (38.2±9.8) dB respectively. Postoperative 3 months at the same frequency of AC thresholds, BC thresholds, and ABG were (42.1±11.3) dB, (26.9±6.6) dB, and (15.2±9.1) dB. Preoperative and postoperative of AC threshold and ABG were statistically significant at 0.5, 1, 2, 4 kHz ( value was 13.270 and13.948, both <0.01), and yet the BC threshold was not statistically significant before and after surgery at the same frequency (=0.418, >0.05). 980 nm fiber laser stapes floor fenestration is an effective treatment for conductive deafness caused by otosclerosis and ossicular malformation.

摘要

探讨980 nm光纤激光镫骨底板开窗术治疗耳硬化症及听骨链畸形所致传导性耳聋的手术疗效。回顾性分析58例(耳)诊断为耳硬化症(49耳)及听骨链畸形(9耳)并接受980 nm半导体激光小开窗镫骨手术治疗患者的数据。比较手术前及术后3个月0.5、1、2、4 kHz纯音频率下的气导(AC)阈值、骨导(BC)阈值和气骨导间距(ABG),总结980 nm光纤激光的优势及注意事项。采用配对检验(SPSS 26.0软件)分析听力数据。57例(耳)均成功完成光纤激光镫骨开窗及人工镫骨植入术,另1例镫骨底板分离浮动畸形患者术后听力较术前下降。术前0.5、1、2、4 kHz频率的AC阈值、BC阈值及ABG分别为(65.4±9.7)dB、(27.2±8.9)dB、(38.2±9.8)dB。术后3个月相同频率的AC阈值、BC阈值及ABG分别为(42.1±11.3)dB、(26.9±6.6)dB、(15.2±9.1)dB。术前与术后AC阈值及ABG在0.5、1、2、4 kHz差异有统计学意义(值分别为13.2和13.948,均<0.01),而相同频率下BC阈值手术前后差异无统计学意义(=0.418,>0.05)。980 nm光纤激光镫骨底板开窗术是治疗耳硬化症及听骨链畸形所致传导性耳聋的有效方法。

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