Grote J J
ENT-Department, University Hospital Leiden, The Netherlands.
Am J Otol. 1998 Sep;19(5):565-8.
The results of the first cohort of 60 cavity reconstructions with hydroxyapatite with a minimum follow-up period of 15 years were studied.
The study design was a retrospective study.
A total of 60 patients had a follow-up period of >15 years. In four patients, not all data were available. Therefore, 56 patients were included in the study. They had a combination of cavity problems and hearing loss.
The ear canal was reconstructed with a canal wall prosthesis of porous hydroxyapatite. The ossicular chain was reconstructed with an incus or incus-stapes prosthesis of dense hydroxyapatite.
After 15 years, 42 patients (75%) had an intact reconstructed ear canal. The main problem for failure was the recurrent purulent middle ear infection and not cholesteatoma. The histology of the retrieved canal wall showed a good remodeling in living bone tissue. After 15 years, 34 patients had a normal ear canal and an ossicular chain. Of these patients, 7.05% had an air-bone gap closure within 20 dB.
Long-term results of cavity reconstruction with hydroxyapatite are possible. The main problem is recurrent mucosal disease of the new middle ear-mastoid cleft.
研究首批60例采用羟基磷灰石进行中耳腔重建且随访期至少为15年的结果。
本研究设计为回顾性研究。
共有60例患者随访期超过15年。4例患者并非所有数据均可用。因此,56例患者纳入研究。他们存在中耳腔问题合并听力损失。
采用多孔羟基磷灰石耳道假体重建耳道。采用致密羟基磷灰石砧骨或砧镫关节假体重建听骨链。
15年后,42例患者(75%)重建耳道完整。失败的主要问题是复发性化脓性中耳感染而非胆脂瘤。取出的耳道壁组织学显示在活骨组织中有良好的重塑。15年后,34例患者耳道及听骨链正常。其中,7.05%的患者气骨导差缩小至20 dB以内。
采用羟基磷灰石进行中耳腔重建可获得长期效果。主要问题是新形成的中耳-乳突裂隙复发性黏膜疾病。