Mills R P
Department of Otolaryngology, University of Dundee, UK.
Clin Otolaryngol Allied Sci. 1996 Dec;21(6):499-503. doi: 10.1111/j.1365-2273.1996.tb01099.x.
Operations to reconstruct defects of the ossicular chain conventionally involve the creation of a link between the malleus handle or tympanic membrane and the head of the stapes. These procedures do not produce satisfactory hearing results in a significant number of patients and must be considered unphysiological. Over the last 5 years the author has been using an alternative approach for patients with defects of the long process of the incus but an intact stapes arch in which the defect is repaired with a small cortical bone graft. Because of the way in which the graft fits over the stump of the long process it is called the 'sleeve' technique. So far 30 operations have been carried out and 21 patients have been followed for more than 1 year. The hearing results in these patients have been compared with those for patients with the same ossicular defect who have undergone conventional reconstructions by the same surgeon. There were significantly larger hearing gains (P < 0.04) and smaller postoperative air-bone gaps (P < 0.04) at 1 year in the 'sleeve' technique group. The technique is easy to perform and therefore appears to be the technique of choice in ears with partial erosion of the long process of the incus.
传统上，用于重建听骨链缺损的手术通常需要在锤骨柄或鼓膜与镫骨头之间建立连接。这些手术在相当多的患者中并不能产生令人满意的听力结果，而且必须被认为是不符合生理的。在过去5年中，对于砧骨长突缺损但镫骨弓完整的患者，作者一直采用一种替代方法，即使用小块皮质骨移植修复缺损。由于移植骨覆盖在长突残端的方式，这种方法被称为“套管”技术。到目前为止，已经进行了30例手术，21例患者随访时间超过1年。将这些患者的听力结果与同一外科医生进行传统重建的相同听骨缺损患者的听力结果进行了比较。“套管”技术组在1年时听力增益显著更大（P < 0.04），术后气骨导间距更小（P < 0.04）。该技术操作简便，因此似乎是砧骨长突部分侵蚀的耳朵的首选技术。
