摘要
目的观察钛人工听骨在慢性中耳炎患者进行Ⅰ期听力重建鼓室成形术中的应用情况,为钛人工听骨的临床使用提供参考。方法以2008年9月至2010年6月在南昌大学第一附属医院耳鼻咽喉-头颈外科住院手术的慢性中耳炎患者为研究对象,回顾性分析299例(耳)使用钛人工听骨进行I期听力重建鼓室成形术的疗效,对患者进行纯音听力检查,比较术前和术后气骨导差的变化。手术方法均为开放式鼓室成形术,视上鼓室外侧壁(桥)保留与否和植入人工听骨类型的不同,将术后听力结果随访完整的112例病例分为三组:组一:留桥鼓室成形术,植入PORP;组二:断桥鼓室成形术,植入PORP;组三:断桥鼓室成形术,植入TORP。结果 :术后随访3月至1年,术后气骨导差≤20dB者共43例,其中植入部分人工听骨(PORP)42例,植入全人工听骨(TORP)1例。组一与组二比较,术后气骨导差无统计学意义,但各组之间术前与术后气骨导差改善均有统计学意义,植入PORP组比植入TORP组术后气骨导差改善更明显,且有统计学意义。所有病例无胆脂瘤复发,3例人工听骨排出。结论手术方式与术后听力改善无关,植入的方式与术后听力改善有关。
Objective To review treatment outcomes of one stage tympanoplasty using titanium ossicular prosthesis in patients with chronic otitis media. Method Two hundred and twenty nine patients with chronic otitis media received one stage tympanoplasty using titanium ossicular prosthesis between September 2008 and June 2010. Pre-and postoperative pure tone thresholds and air-bone gap were compared. Tympanoplasty was conducted using an open approach. One hundred and twelve cases with complete follow up data were reviewed and divided into 3 groups based on whether the lateral attic bone wall （bridge） was preserved and the type of titanium ossicular prosthesis used：. preservation of bridge plus PORP （Group 1）, no bridge plus PORP （Group 2）, and no bridge plus TORP （Group 3）. The 112 patient were followed up for 3 months to 1 years and their pre-and postoperative pure tone threshold results were available for comparison. Result Postoperative air-bone gap was reduced to ≤20 dB in 43 cases （42 using PORP and 1 using TORP）. While post-operative air-bone gap was decreased compared to before surgery among all three groups, especially for those using PORP as compared to those using TORP, the improvement was not statistically different between Groups 1 and 2, There was no recurrence of Cholesteatoma. Titanium ossicular prosthesis was protruded in 3 patients. Conclusion Whether bone bridge is preserved does not appear to affect postoperative hearing results, whereas the type of titanium ossicular prosthesis does.
出处
《中华耳科学杂志》
CSCD
北大核心
2012年第1期31-34,共4页
Chinese Journal of Otology
基金
江西省卫生厅课题资助项目编号:20121054
关键词
听小骨假体
鼓室成形术
听骨链重建
慢性中耳炎
Ossicular Prosthesis
Tympanoplasty
Ossicular chain reconstruction
Chronic Otitis media
