Velasco Gianfranco, Alshaikh Hamzah, Lee Chan Mi, Jeon Min Chae, Han Jae Sang, Seo Jae Hyun, Park Shi Nae
Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seochogu, Seoul, 06591, Republic of Korea.
Department of Otolaryngology-Head and Neck Surgery, Rizal Medical Center, Pasig City, Metro Manila, Philippines.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):1791-1799. doi: 10.1007/s00405-024-09063-4. Epub 2024 Nov 28.
To report our institution's experience with patients who underwent subtotal petrosectomy (STP) for refractory ear disease who are candidates for cochlear implant (CI) and to highlight simultaneous STP with CI its advantages, surgical outcomes, post-operative complications management, and considerations for staging a procedure.
A retrospective study was performed in a single tertiary referral university hospital. The medical records of seventy patients (70 ears) who underwent STP for refractory ear disease who were candidates for CI were retrospectively evaluated.
Seventy adults (age range 30-85) underwent STP with a median follow-up of 4.8 years (range 1.5-18.2). Twenty-seven (38.5%) had previous mastoid surgeries before STP. Most patients underwent simultaneous STP and CI (n = 36, 51.5%), followed by STP only (n = 28, 40%), with a smaller group having staged CI after STP (n = 6, 8.5%). Patients who underwent simultaneous STP and CI showed significant improvements in several measures, with mean pre-operative pure tone audiometry (PTA) of 98.7 dB HL (range 85-118; SD: ± 9.2) improving to 39.3 dB HL post-operatively (range 25-50; SD: ± 9.3, p < 0.001), mean pre-operative categories of auditory performance (CAP) score of 1.6 (range 0-4; SD: ± 1.3), increasing to 5.6 post-operatively (range 4-7; SD: ± 1.3, p < 0.001), and mean pre-operative open-set adult sentence score of 6.8% (range 0-40%), improving to 78.4% post-operatively (range 40-100%, p < 0.001). Three of the 36 patients (8.3%) who had simultaneous STP and CI developed post-operative complications (median follow-up: 4.2 years). No disease recurrence was reported.
STP is an effective intervention for refractory middle ear and mastoid diseases. It allows for a thorough disease removal and prepares the ear for subsequent implantation procedures. Simultaneous STP and CI provide the advantage of hearing rehabilitation, disease control, and a comparable complication rate to that of conventional CI procedures.
报告我院对因难治性耳部疾病而接受岩骨次全切除术（STP）且适合人工耳蜗植入（CI）的患者的治疗经验，并重点介绍同期进行STP和CI的优势、手术效果、术后并发症处理以及分期手术的注意事项。
在一家单一的三级转诊大学医院进行了一项回顾性研究。对70例因难治性耳部疾病而接受STP且适合CI的患者（70耳）的病历进行了回顾性评估。
70例成年人（年龄范围30 - 85岁）接受了STP，中位随访时间为4.8年（范围1.5 - 18.2年）。27例（38.5%）在STP之前曾接受过乳突手术。大多数患者同期进行了STP和CI（n = 36，51.5%），其次是仅接受STP（n = 28，40%），一小部分患者在STP后分期进行CI（n = 6，8.5%）。同期进行STP和CI的患者在多项指标上有显著改善，术前平均纯音听力测定（PTA）为98.7 dB HL（范围85 - 118；标准差：±9.2），术后改善至39.3 dB HL（范围25 - 50；标准差：±9.3，p < 0.001）；术前平均听觉表现类别（CAP）评分为1.6（范围0 - 4；标准差：±1.3），术后增至5.6（范围4 - 7；标准差：±1.3，p < 0.001）；术前成人开放式语句得分平均为6.8%（范围0 - 40%），术后改善至78.4%（范围40 - 100%，p < 0.001）。36例同期进行STP和CI的患者中有3例（8.3%）出现术后并发症（中位随访时间：4.2年）。未报告疾病复发情况。
STP是治疗难治性中耳和乳突疾病的有效干预措施。它能彻底清除病灶，并为后续植入手术做好耳部准备。同期进行STP和CI具有听力康复、疾病控制的优势，且并发症发生率与传统CI手术相当。
