耳内镜和显微镜下镫骨手术的比较  

A Comparison of Endoscopic and Microscopic Stapes Surgeries

作　　者：赵宇[1] 郑永波[1] 娄麟[1] 安平 高燕 陈敏 彭皎皎[1] 

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科,成都610041 [2]成都上锦南府医院/四川大学华西医院上锦医院耳鼻咽喉头颈外科,成都611730

出　　处：《中华耳科学杂志》2017年第4期408-411,共4页Chinese Journal of Otology

基　　金：四川省科技厅国际合作项目2016HH0064~~

摘　　要：目的采用回顾性研究方法,探讨总结耳内镜下镫骨手术的疗效及优缺点,为其临床应用提供参考。方法收集分析近两年来分别采用耳内镜下(14例)和显微镜下(20例)人工镫骨手术患者的临床资料,通过观察比较两组患者手术方式、手术时间、听力改善程度及术后并发症等的差别,分析耳内镜下镫骨手术的疗效和优势。结果两组患者术后气骨导差较术前均明显降低,差异具有统计学意义(P<0.05)。两组病例术中术后并发症发生率无统计学差异。耳内镜组手术所需时间较显微镜组长,差异有统计学意义(P<0.05)。然而,随着耳内镜下手术操作熟练程度的增加,后期两组病例之间手术所需时间的比较无统计学差异(P>0.05)。结论耳内镜下行镫骨手术,在探查听骨链、重建听力方面,相对于显微镜下操作的优势在于观察仔细、视野清晰、创伤小、术后恢复快等,具有较好的推广应用价值。Objective The aim of this study was to compare the effecacy and advantages between endoscopic and microscopic stapes surgeries. Methods Data from patients who received endoscopic（n=14） or microscopic（n=20）stapes surgeries in the past two years were analyzed. The surgery techniques, operation time, postoperative hearing improvements and complications, as well as other aspects, were compared to demonstrate advantages and efficacy of endoscopic stapes surgery. Results Postoperative air-bone gaps（ABGs） of were significantly lower than before operation in both groups（P0.05） with no significant difference in the incidence of postoperative complications between the two groups. The surgery time in microscopic surgeries was initially shorter than endoscopic surgeries（P0.05）, although there was no significant difference between the two groups in later cases（P 0.05）. Conclusions The advantages of endoscopic stapes surgeries are mainly in ossicular chain exploration and hearing reconstruction, providing better views, less trauma and faster recovery after surgery. Therefore, endoscopic stapes surgery deserves increased clinical application.

关 键 词：耳内镜 显微镜 镫骨 手术 

分 类 号：R764[医药卫生—耳鼻咽喉科]