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镫骨翻修手术:术中发现及听力学结果。一项多中心研究。

Stapes revision surgery: intraoperative findings and audiological results. A multicentric study.

作者信息

Bruschini Luca, Lazzerini Francesco, Capobianco Silvia, Marconi Ottavia, Canale Andrea, Albera Andrea, Covelli Enrico, Canzi Pietro, Laborai Andrea, Cuda Domenico, Berrettini Stefano

机构信息

Otolaryngology, Audiology, and Phoniatrics Unit, University of Pisa, Pisa, Italy.

Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2025 Jun;45(Suppl. 1):S61-S70. doi: 10.14639/0392-100X-suppl.1_3-45-2025-A1339.

Abstract

OBJECTIVE

To explore the results of revision stapes surgery within a multicentric cohort, focusing on hearing improvements and correlation with the type of postoperative hearing loss experienced and related findings during the revision procedure.

METHODS

A retrospective study of 308 consecutive revision stapes surgeries performed ay 5 Otorhinolaryngologic Units in Pisa, Turin, Pavia, Piacenza, and Rome between 2010 and 2023 was accomplished.

RESULTS

The most frequent causes leading to revision stapes surgery were prosthesis dislocation (56.1%), use of a short prosthesis during primary surgery (13.9%), and an eroded incus (17.2%). The median air conduction threshold significantly improved after revision surgery, while the bone conduction threshold remained stable.

CONCLUSIONS

Revision stapes surgery effectively improves hearing in patients with unsuccessful initial operations, with a significant reduction in the air-bone gap (ABG). The audiological results in our patients are favourable. ABG closure within 10 dB was achieved in 57.2% of cases and within 20 dB in 76% of cases. Stapes revision surgery is feasible and provides an acceptable success rate.

摘要

目的

在多中心队列中探讨镫骨手术翻修的结果,重点关注听力改善情况以及与术后听力损失类型和翻修手术期间相关发现的相关性。

方法

对2010年至2023年期间在比萨、都灵、帕维亚、皮亚琴察和罗马的5个耳鼻喉科单位连续进行的308例镫骨手术翻修进行了回顾性研究。

结果

导致镫骨手术翻修的最常见原因是假体脱位(56.1%)、初次手术时使用短假体(13.9%)和砧骨侵蚀(17.2%)。翻修手术后气导阈值中位数显著改善,而骨导阈值保持稳定。

结论

镫骨手术翻修有效地改善了初次手术失败患者的听力,气骨导间距(ABG)显著减小。我们患者的听力学结果良好。57.2%的病例气骨导间距闭合在10 dB以内,76%的病例在20 dB以内。镫骨翻修手术是可行的,且成功率可接受。

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