Feghali J G, Barrs D M, Beatty C W, Chen D A, Green J D, Krueger W W, Shelton C, Slattery W H, Thedinger B S, Wilson D F, McElveen J T
Montifiore Medical Center, Bronx, New York, USA.
Laryngoscope. 1998 Jun;108(6):829-36. doi: 10.1097/00005537-199806000-00010.
To determine the feasibility and efficacy of using a bone cement, Oto-Cem, to reconstruct the ossicular chain.
Prospective clinical trial on nine consecutively chosen adult patients with ossicular chain defects.
Nine patients with ossicular chain defects involving the long process of the incus were treated at the Carolina Ear and Hearing Clinic. The ossicular chain was reconstructed using bone cement by itself or in conjunction with a stapes prosthesis.
Preoperative audiograms were compared with audiograms 3, 6, and 12 months after reconstruction.
There was a mean pure-tone average (PTA) improvement of 15 dB in patients undergoing incus to stapes suprastructure reconstruction with the bone cement. The incus to mobile footplate reconstruction (using a stapes prosthesis attached to the newly reconstructed incus) resulted in a 34-dB PTA postoperative improvement. Two of the three patients with incus to oval window repairs experienced a 10-dB improvement in PTA. One of the three patients experienced a loss in speech discrimination and a 2-dB loss in PTA.
Despite the limited number of patients, this preliminary study demonstrates the effectiveness of Oto-Cem in reconstructing a foreshortened incus. There was a substantial hearing improvement in all but one patient in the incus to stapes or the incus to footplate categories.
确定使用骨水泥Oto-Cem重建听骨链的可行性和有效性。
对连续选取的9例成年听骨链缺损患者进行前瞻性临床试验。
9例听骨链缺损累及砧骨长突的患者在卡罗来纳耳与听力诊所接受治疗。使用骨水泥单独或联合镫骨假体重建听骨链。
将术前听力图与重建后3个月、6个月和12个月的听力图进行比较。
采用骨水泥进行砧骨至镫骨上部结构重建的患者，纯音平均听阈（PTA）平均改善15 dB。砧骨至活动足板重建（使用附着于新重建砧骨的镫骨假体）术后PTA改善34 dB。3例进行砧骨至卵圆窗修复的患者中有2例PTA改善10 dB。3例患者中有1例言语辨别力下降，PTA下降2 dB。
尽管患者数量有限，但这项初步研究证明了Oto-Cem在重建缩短的砧骨方面的有效性。在砧骨至镫骨或砧骨至足板组中，除1例患者外，所有患者的听力均有显著改善。
