Shea J J
Shea Clinic, Memphis, Tennessee 38119.
Am J Otol. 1994 Jan;15(1):71-3.
Localized anterior otosclerosis is found in about 80 percent of primary stapedectomy operations. For these patients, partial stapedectomy with vein graft is recommended. Obliterative otosclerosis is the pathology found in the remaining 20 percent of primary stapedectomy operations. In these cases, stapedectomy with lining membrane of the middle ear or vein graft is the procedure of choice. Revision stapedectomy may improve conductive hearing loss caused by (1) migration and/or dislocation of the prosthesis, (2) eversion of the lining membrane of the vestibule with resulting dislocation of the prosthesis and possible erosion of the lower incus, (3) bony closure of the oval window, or (4) epitympanic fixation of the incus and/or malleus. Successful operative techniques used in primary and revision stapedectomy are described.
在约80%的初次镫骨切除术病例中可发现局限性耳硬化症。对于这些患者，建议采用带静脉移植的部分镫骨切除术。闭塞性耳硬化症是其余20%初次镫骨切除术病例中发现的病理情况。在这些病例中，采用中耳衬里膜或静脉移植的镫骨切除术是首选术式。翻修镫骨切除术可改善由以下情况导致的传导性听力损失：(1) 假体移位和/或脱位；(2) 前庭衬里膜外翻导致假体脱位以及可能的下砧骨侵蚀；(3) 卵圆窗骨质封闭；或(4) 砧骨和/或锤骨上鼓室固定。文中描述了初次和翻修镫骨切除术中使用的成功手术技巧。
