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[镫骨翻修术:临床发现与结果]

[Stapes revisions: clinical findings and results].

作者信息

Peter B, Grossenbacher R

机构信息

Klinik für Ohren-Nasen-Halsheikunde, Hals- und Gesichtschirurgie, Kantonsspital St. Gallen/Schweiz.

出版信息

Laryngorhinootologie. 1995 Jul;74(7):399-402. doi: 10.1055/s-2007-997768.

Abstract

By correlating the intraoperative findings and the postoperative hearing gain it was attempted to determine the recommendable intraoperative management in stapesrevisions in order to obtain the best postoperative hearing. In a retrospective study the findings of 39 stapes revision operations were analyzed. In most of the cases hearing one year postoperatively was compared with preoperative hearing. The prognosis for good hearing was best following replacement of the prosthesis where the prosthesis was too short or dislocated, or in the presence of a loosened wire. Where treatment only entailed retightening the loosened wire at the long process of the incus, postoperative hearing did not improve. Patients with an obliterative otosclerosis or an additional fixed incus had a less favorable prognosis. Overall a postoperative air bone gap of 10 dB or below was obtained in 44% of the patients and a postoperative air bone gap of 20 dB or below in 77% of the patients. Twenty-one percent of the patients remained unchanged, and in one patient postoperative deterioration of the hearing was detected.

摘要

通过将术中发现与术后听力改善情况相关联,试图确定镫骨手术翻修术中可推荐的术中处理方法,以获得最佳的术后听力。在一项回顾性研究中,分析了39例镫骨手术翻修的结果。在大多数病例中,将术后一年的听力与术前听力进行了比较。在假体过短或脱位、或存在钢丝松动的情况下更换假体后,听力良好的预后最佳。若治疗仅需在砧骨长突处重新拧紧松动的钢丝,术后听力并无改善。患有闭塞性耳硬化症或额外固定砧骨的患者预后较差。总体而言,44%的患者术后气骨导差为10dB或更低,77%的患者术后气骨导差为20dB或更低。21%的患者听力无变化,1例患者术后听力恶化。

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