钛人工听骨植入术后假体脱出原因分析  

Preliminary Analysis of Causes of Titanium Prosthesis Extrusion after Ossicular Chain Reconstruction

作　　者：周永青[1] 李晓明[1] 邵永良[1] 李震[1] 李建红[1] 陈旭真[1] 王玲[1] 

机构地区：[1]解放军白求恩国际和平医院耳鼻咽喉头颈外科,石家庄050082

出　　处：《中华耳科学杂志》2014年第3期448-451,共4页Chinese Journal of Otology

摘　　要：目的回顾性分析钛人工听骨(宾格牌)在植入术后假体脱出的原因,以期进一步提高人工听骨植入手术的成功率。方法自2007年2月到2013年7月间,共完成一期钛金属人工听骨植入听骨链重建术206耳。其中,POP164耳,TOP42耳。结果 206例中,共计脱出12个,占5.8%。分别是术后3周感染脱出3耳;随访中钛听骨渐外露至完全排出9耳。致钛听骨渐外露的因素有:1)钛听骨高度过高。2)钛听骨歪斜。3)软骨片过小、薄、移位。4)含气腔渐变小。结论植入材料选择、手术技巧、术后中耳含气腔的变化均是影响假体脱出的因素。其中,就宾格牌钛听骨而言,其支撑面的平面形态设计和锐利的切缘可能是导致术后远期假体脱出的一个潜在因素。Objective To understand the cause of extrusion of Spigger titanium prosthesis following ossicular chain re-construction to improve treatment outcomes. Methods Two hundred and six cases of ossicular chain reconstruction using the Spigger titanium prosthesis by a single ear surgeon from February of 2007 to July of 2013 were reviewed. Both PORP （n=157 cases） and TORP （n=49 cases） prostheses were used in the 206 cases. Results Of the 206 cases, extrusion occurred in 12 cases （5.8%）. Inflammation during the first three weeks after the surgery caused extrusion in 3 cases. In 9 cases the Titanium prosthesis extruded gradually over six months after the surgery. The extrusion from the middle ear after surgery appeared to be related to the following factors：1） excessively high prosthesis positioning, 2） slanting prosthesis placement, 3） gradual car-tilage displacement from being too small or too thin, 4） gradual decrease in middle ear air cells size, and 5） design defects in the Spigger titanium prosthesis. Conclusions Implant material, middle ear inflammation in the early stage after surgery, sur-geon skill levels, middle ear air cell size change after surgery are all possible causes for prosthesis extrusion. For the Spigger titanium prosthesis, some design defects may also contribute to the extrusion after surgery.

关 键 词：手术 中耳 钛人工听骨 脱出 

分 类 号：R322.922[医药卫生—人体解剖和组织胚胎学]