同种异体软骨听骨赝复物与羟基磷灰石听骨赝复物修复听骨链损伤的比较  

Homologous cartilage ossicular prosthesis versus hydroxyapatite ossicular prosthesis for repair of auditory ossiclar injury

作　　者：高红[1] 姜学钧[2] 杨会军[2] 

机构地区：[1]沈阳市第五人民医院耳鼻喉科,辽宁省沈阳市110023 [2]中国医科大学附属第一医院耳鼻咽喉头颈外科,辽宁省沈阳市110001

出　　处：《中国组织工程研究与临床康复》2010年第25期4594-4598,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:以往多采用同种异体软骨听骨赝复物作为听骨链重建的材料,近年来羟基磷灰石听骨赝复物已广泛地应用于鼓室成形术的临床工作中。而目前有关两种听骨赝复物在鼓室成形术、听骨链重建中的临床疗效比较尚无相关报道。目的:比较两种听骨赝复物的临床疗效,旨在探求更适宜临床推广应用的听骨赝复物。方法:将进行鼓室成形、听骨链重建术的慢性中耳炎患者60例分为同种异体软骨听骨赝复物组和羟基磷灰石听骨赝复物组,两组在术前、术后进行纯音听力测试,以语言频率区(0.5,1.0,2.0kHz)听阈气导平均值及气骨导差平均值统计,取最后一次(至少6个月以后)复查听力结果作为组间对比指标之一。同时记录两组病例移植鼓膜愈合情况,即移植鼓膜良好上皮化的时间,两组听骨赝复物的脱出率。结果与结论:在相同病变类型、相同术式患者中,同种异体软骨听骨赝复物与羟基磷灰石听骨赝复物植入后听力恢复水平方面差异不显著(P>0.05),术后移植鼓膜愈合情况方面差异不显著(P>0.05)。在相同病变类型、相同术式的术后赝复物脱出率均为0。提示同种异体软骨听骨赝复物与羟基磷灰石听骨赝复物在慢性中耳炎患者行鼓室成形、听骨链重建术中的临床疗效相似。BACKGROUND：Homologous cartilage ossicular prosthesis is usually applied to reconstruct ossicular chain.Recently,hydroxyapatite ossicular prosthesis has been widely used for clinical practice of tympanoplasty.There are no current studies reporting the clinical efficacy of homologous cartilage ossicular prosthesis and hydroxyapatite ossicular prosthesis in tympanoplasty and reconstruction of ossicular chain.OBJECTIVE：To find a suitable ossicular prosthesis by comparing the clinical effect of homologous cartilage ossicular prosthesis and hydroxyapatite ossicular prosthesis.METHODS：Sixty patients with chronic otitis media undergoing tympanoplasty and reconstruction of ossicular chain were divided into homologous cartilage ossicular prosthesis group and hydroxyapatite ossicular prosthesis group.Two groups were subjected to pure tone testing before and after surgery.The average hearing threshold air conduction and the average air-bone gap were calculated in speech frequency area（0.5,1.0,2.0 kHz）,the hearing results of last recheck（at least 6 months later） served as one of the indicators for comparisons between the two groups.The tympanic membrane healing of two groups of cases was recorded,that is the time for epithelium of graft tympanic membrane,the extrusion rate of ossicular prosthesis in two groups was also recorded.RESULTS AND CONCLUSION：As for patients with the same lesion type and the same surgical approach,the hearing improvement did not differ significantly between the homologous cartilage ossicular prosthesis and hydroxyapatite ossicular prosthesis（P 0.05）.The healing of tympanic membrane was not significantly different（P 0.05）.The ratio of ossicular prosthesis exodus was 0% in both homologous cartilage ossicular prosthesis and hydroxyapatite ossicular prosthesis.The homologous cartilage ossicular prosthesis has similar clinical effect with hydroxyapatite ossicular prosthesis for tympanoplasty and reconstruction of ossicular chain.

关 键 词：慢性中耳炎 同种异体软骨 羟基磷灰石 听骨赝复物 鼓室成形术 

分 类 号：R318[医药卫生—生物医学工程]