Swartz J D, Lansman A K, Berger A S, Wolfson R J, Bell G, Popky G L, Swartz N G
Radiology. 1986 Jan;158(1):179-82. doi: 10.1148/radiology.158.1.3940377.
We used computed tomography (CT) to evaluate 44 patients who had undergone stapedectomy with insertion of a prosthesis. Several patients had poor surgical results, including recurrent conductive hearing loss, vertigo, and sensorineural hearing loss. Conductive hearing loss occurring immediately after the procedure was most often caused by anatomic limitations or surgical technique. Causes of delayed or recurrent conductive hearing loss included reparative granuloma formation, incus necrosis (at the attachment of the wire), prosthesis subluxation (most often posterior), and regrowth of otosclerosis, which occasionally is further complicated by incus dislocation. We found that CT is often diagnostic when these complications occur. Immediate sensorineural hearing loss or vertigo can be self-limited if caused by serous labyrinthitis. When delayed, these symptoms may be due to perilymph fistula. If caused by the latter, CT may not yield abnormal findings unless subluxation of the prosthesis into the vestibule has occurred.
我们使用计算机断层扫描（CT）对44例接受了镫骨切除术并植入假体的患者进行评估。部分患者手术效果不佳，包括反复出现的传导性听力损失、眩晕和感音神经性听力损失。术后立即出现的传导性听力损失最常见的原因是解剖学限制或手术技术问题。迟发性或复发性传导性听力损失的原因包括修复性肉芽肿形成、砧骨坏死（在钢丝附着处）、假体半脱位（最常见于后方）以及耳硬化症复发，后者偶尔还会因砧骨脱位而进一步复杂化。我们发现，当这些并发症发生时，CT常常具有诊断价值。如果浆液性迷路炎导致立即出现感音神经性听力损失或眩晕，可能为自限性。当出现延迟时，这些症状可能是由于外淋巴瘘所致。如果是由后者引起，除非假体半脱位进入前庭，否则CT可能不会显示异常结果。
