Han W W, Incesulu A, McKenna M J, Rauch S D, Nadol J B, Glynn R J
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Laryngoscope. 1997 Sep;107(9):1185-92. doi: 10.1097/00005537-199709000-00006.
Seventy-four revision stapedectomies performed consecutively over 10 years (1986 to 1995) were reviewed retrospectively. The most common intraoperative findings were incus erosion, prosthesis displacement, and oval window closure. Incus erosion was more frequently associated with multiple revisions. The postoperative results were reported using the conventional method (postoperative air minus preoperative bone) as well as the guidelines recently published by the American Academy of Otolaryngology--Head and Neck Surgery (postoperative air minus postoperative bone), with success rates of postoperative air-bone gap closure to within 10 dB after revision surgery of 51.6% and 45.6%, respectively. Patients with persistent conductive hearing loss (large residual air-bone gaps) after primary stapedectomy had poorer postrevision hearing results. Sensorineural hearing loss (defined as a drop in bone pure-tone average of more than 10 dB) occurred in four cases (5.4%). The number of revision surgeries, variations in operative techniques using laser or drill, and the ossicle to which the prosthesis was attached did not statistically affect the postoperative air-bone gaps. These results were compared with previously published data.
对1986年至1995年连续10年间进行的74例镫骨切除术翻修病例进行回顾性研究。术中最常见的发现是砧骨侵蚀、假体移位和卵圆窗封闭。砧骨侵蚀更常与多次翻修相关。采用传统方法（术后气导减去术前骨导）以及美国耳鼻咽喉头颈外科学会最近发布的指南（术后气导减去术后骨导）报告术后结果，翻修手术后气骨导差距缩小至10dB以内的成功率分别为51.6%和45.6%。初次镫骨切除术后持续存在传导性听力损失（气骨导差距大）的患者翻修后听力结果较差。4例（5.4%）出现感音神经性听力损失（定义为骨导纯音平均值下降超过10dB）。翻修手术的次数、使用激光或钻头的手术技术差异以及假体附着的听小骨对术后气骨导差距无统计学影响。将这些结果与先前发表的数据进行比较。
