羟基磷灰石与钛合金听骨赝复物应用于胆脂瘤中耳炎听力重建效果比较  

Comparison of the Outcome between Hydroxyapatite and Titanium Prosthesis Used in Ossiculoplasty and Mastoidectomy to treat Cholesteatomatous Otitis Media

作　　者：张治华[1] 黄琦[1] 杨军[1] 汪照炎[1] 吴皓[1] 

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉头颈外科,上海200092

出　　处：《听力学及言语疾病杂志》2010年第3期208-210,共3页Journal of Audiology and Speech Pathology

基　　金：上海市科委重大项目(08411954500);国家自然科学基金(30973307)联合资助

摘　　要：目的探讨不同材料和类型听骨赝复物应用于胆脂瘤中耳炎听力重建的疗效。方法对142例(142耳)胆脂瘤中耳炎患者分别用钛合金(64例)和羟基磷灰石(78例)作为听骨赝复物行开放式鼓室成形及听力重建术,两组再分别分为部分听骨赝复物亚组和全听骨赝复物亚组,随访12个月,比较两组0.5、1、2、4kHz纯音平均听阈、平均气骨导差和听力重建成功率。结果钛合金组和羟基磷灰石组气导平均听阈分别降低11.88、11.41dB,气骨导差分别缩小7.80、6.98dB,手术成功率分别为54.69%、44.87%,前者较后者效果略优,但无统计学差异。从4kHz平均听阈及气骨导差看,钛合金组的部分和全听骨赝复物亚组手术成功率(分别为63.33%和61.76%)高于总体。部分听骨赝复物亚组术后听力学结果优于全听骨赝复物亚组。结论开放式鼓室成形术伴一期听力重建术治疗胆脂瘤型中耳炎,应用钛合金和羟基磷灰石听骨雁复物对术后听力康复均有效,前者对于4kHz听力的提高可能更有效。Objective To study the effects of different prosthesis used in ossiculoplasty on mastoidectomy of treating cholesteatomatous otitis media. Methods 142 patients with cholesteatoma were treated by mastoidectomy with ossiculoplasty in a single stage. They were divided into 2 groups according to material of prosthesis （hydroxypatite or titanium）. Hearing thresholds were reviewed in the 12 months follow-up. Results The both groups showed air threshold improved by 11.88 and 11.41 while the air-bone gaps were 7.80 and 6.98 dB. The success rates were 54.69% and 44.87% with the titanium group being better. The titanium prosthesis performed well at the high frequency （4 kHz）. Oonclusion The outcomes of ossiculoplasty with mastoidectomy in treating cholesteatoma is influenced by prosthesis made of different material. Either hydroxypatite or titanium has showed great effects in the treatment with the latter being better. A long-term follow up to evaluate the influence of different prosthesis is needed.

关 键 词：胆脂瘤中耳炎 听力重建 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]