Fisch U
HNO. 1979 Nov;27(11):361-7.
468 stapes operations have been performed at the ENT-Department of the University of Zurich between 1970 and 1978. In one half of the cases, a total or partial removal of the footplate with introduction of a wire connective tissue prosthesis has been used. In the other half, the operation consisted in a limited fenestration of the footplate, which was large enough to accept a wire teflon piston of 0.6 mm diameter. Statistical analysis of the results of both methods shows a better bone conduction threshold for the speech frequencies (500, 1,000 and 2,000 Hz) as well as for air conduction at 4,000 cps after stapedotomy. Complete postoperative deafness occurred in one case following stapedectomy (0.3% of patients with primary operation). The advantages of stapedotomy over stapedectomy are the following: 1. Less trauma to the inner ear, 2. better stability of the position of the prosthesis and 3. better adaptation of the length of the prosthesis. The surgical steps used for stapedotomy are described.
1970年至1978年间，苏黎世大学耳鼻喉科共进行了468例镫骨手术。其中一半病例采用了完全或部分切除镫骨足板并植入钢丝结缔组织假体的方法。另一半病例则采用了有限的镫骨足板开窗术，开窗大小足以容纳直径为0.6毫米的钢丝聚四氟乙烯活塞。对这两种方法的结果进行统计分析表明，镫骨切除术后，言语频率（500、1000和2000赫兹）以及4000赫兹气导的骨导阈值更佳。镫骨切除术后有1例患者出现完全性术后耳聋（占初次手术患者的0.3%）。镫骨开窗术优于镫骨切除术的优点如下：1. 对内耳的创伤较小；2. 假体位置的稳定性更好；3. 假体长度的适配性更好。文中描述了镫骨开窗术的手术步骤。
