钛质人工听骨在一期鼓室成形术中的应用  

Application of titanium ossicular prostheses in one stage tympanoplasty

作　　者：赵丹[1] 童步升[1] 邱建新[1] 刘业海[1] 段茂利[1,2] 

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉头颈外科,合肥230032 [2]瑞典皇家卡罗林斯卡医院耳鼻咽喉头颈外科临床科学干预及技术系,斯德哥尔摩17176

出　　处：《中华耳科学杂志》2016年第1期71-74,共4页Chinese Journal of Otology

基　　金：安徽省教育厅自然基金重点项目;2014KJ120~~

摘　　要：目的 研究钛质人工听骨植入在一期鼓室成形术中的疗效。方法 对3 1例用钛质人工听骨行一期鼓室成形术的患者,随访3-6个月。通过计算术前术后纯音测听得出气骨导阈值的平均值,比较手术后气导的恢复情况和手术前后的气骨导差。结果 3 1例患者术后鼓膜愈合良好,未见人工听骨排异反应,及听骨脱出,有1例在术后2个月时发生感染。31耳术前气导听力30.00～88.75dB,平均为（59.27±15.67）dB,术后气导平均听力为（43.10±14.64）dB,与术前相比,差异有统计学意义（P〈0.05）。术前骨导听力为10.00～43.75dB,平均为（23.06±9.18）dB,术后骨导平均听力为（22.82±7.49）dB,与术前相比,差异无统计学意义（P〉0.05）。术前气骨导差（ABG）为11.25～62..5dB,平均为（36.21±11.88）dB,术后ABG平均为（19.40±12.92）dB,二者比较,差异有统计学意义（p〈0.05）。术后ABG≤20dB且ABG较术前缩小15dB为听力提高有效,共有13耳,有效率为41.94%（13/31）。结论 钛质人工听骨植入在一期鼓室成形术中可以取得满意的听力效果,术后并发症少,排除率低,在有听骨链破坏行Ⅰ期鼓室成形术中值得推广应用。Objective To report treatment outcomes of titanium ossicular prostheses in one stage tympanoplasty. Methods Outcomes of one stage tympanoplasty using titanic ossicular replacement prostheses in 31 patients with 3 to 6 months follow-up were retrospectively reviewed. Preand postoperative pure tone thresholds as well as the air-bone gap were compared. Results Repaired tympanic membranes healed well at 1 month follow up in all 31 patients. No os- sicular replacement prosthesis protrusion was found, although infection occurred in 1 patient after 2 months. Mean air conduction hearing threshold was 59.27± 15.67 dB HL before tympanoplasty and 43.10±14.64 dB HL after （P 〈 0.05）. The mean bone conduction hearing threshold was 23.06±9.18 dB HL before operation, and 22.82±7.49 dB HL after （P 〉 0.05）. The mean air bone gap （ABG） was 36.21±11.88 dB before operation, and 19.40± 12.92 dB at followed up （p 〈 0.05）. The total effectiveness rate （post-operative ABG within 15 dB） was 41.94% （13/31）. Conclusion Titanic ossicular replacement prostheses in tympanoplasty with one stage ossicular chain reconstruction can produce satisfactory hearing results, with relatively few complications, and is worth popularizing.

关 键 词：钛质人工听骨 听骨链重建 气骨导差(ABG) 鼓室成形术 

分 类 号：R764.29[医药卫生—耳鼻咽喉科]