Strauss P, Hüren H, Löbner S
Laryngol Rhinol Otol (Stuttg). 1980 Apr;59(4):244-9.
Seldom tympanoplasty damages the inner ear in a substantial amount: From 1814 operations upon chronic inflamed ears 4 patients (0.22%) became deaf, among the other patients bone conduction (b.c.) in the mean increased at 1000 cps for + 0.8 dB and decreased at 4000 cps for - 2.2 dB. In 9.8% b.c. showed an improvement for 10 dB or more at 1000 and 4000 cps, 9.7% showed an corresponding deterioration. For patients it was confirmed on a statistical base, that the influence on bone conduction demonstrated by animal experiments (Tonndorf), was mainly the result of changing the compliance of oval window and of increasing ossicular inertia. By relieving a mobile stapes of an incus which was fixed in the attic, there results an improvement of mobility of the stapedial footplate with increasing b.c. at 1000 and 4000 cps. By interposition of an incus between tympanic membrane and stapes and by myringoplasty with fascia there results an increasing ossicular inertia with increasing b.c. at 1000 cps and decreasing b.c. at 4000 cps. Noise trauma, mechanical trauma and infection are only of slight importance, only in some single cases they will damage the inner ear in a substantial amount.
在1814例慢性炎症耳手术中，有4例患者（0.22%）失聪，其他患者的骨传导（b.c.）平均在1000 cps时增加0.8 dB，在4000 cps时下降2.2 dB。在9.8%的患者中，骨传导在1000 cps和4000 cps时改善了10 dB或更多，9.7%的患者则出现了相应的恶化。从统计学角度证实，动物实验（汤恩多夫）所显示的对骨传导的影响，主要是由于椭圆窗顺应性的改变和听骨链惯性的增加。通过解除固定在鼓室上隐窝的砧骨对镫骨的牵拉，可使镫骨足板的活动度得到改善，骨传导在1000 cps和4000 cps时增加。通过在鼓膜和镫骨之间植入砧骨以及使用筋膜进行鼓膜成形术，会使听骨链惯性增加，骨传导在1000 cps时增加，在4000 cps时下降。噪声创伤、机械创伤和感染的影响较小，仅在某些个别情况下会对内耳造成严重损害。
