开放式及完壁式鼓室成形一期钛人工听骨植入的疗效观察  

The Clinical Effects of Titanic Artificial Ossicle Replacement in Canal Wall-down or Canal Wall-up Tympanoplasty

作　　者：史敏[1] 刘闽[1,2] 梁建平 陆秋天[1] 瞿申红[1] 李东云[1] 唐凤珠[1] Shi Min;Liu Min;Liang Jianping;Lu Qiutian;Qu Shenhong;Li Dongyun;Tang Fengzhu(Department of Otorhinolaryngology, People's Hospital of Guangxi Zhuang Autonomous Region;Guangxi University of Traditional Chinese Medicine, Nanning,530021, China)

机构地区：[1]广西壮族自治区人民医院耳鼻咽喉科,南宁530021 [2]广西中医药大学研究生学院

出　　处：《听力学及言语疾病杂志》2018年第1期33-36,共4页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金(81460097);广西医疗卫生适宜技术研究与开发课题(S20142105);广西壮族自治区卫生厅自筹经费科研课题(Z2014215及Z2015351)资助

摘　　要：目的探讨慢性化脓性中耳炎患者行开放式或完壁式鼓室成形术并一期植入钛人工听骨听力重建的效果。方法回顾性分析2014年2月~2016年2月期间住院手术的157例(164耳)慢性化脓性中耳炎患者的临床资料,其中开放式鼓室成形并一期钛人工听骨植入50耳(开放植入组),未植入钛人工听骨49耳(开放未植入组);完壁式鼓室成形并一期钛人工听骨植入42耳(完壁植入组),未植入钛人工听骨23耳(完壁未植入组)。统计并比较各组患者术前和术后3个月的纯音听阈,评估不同术式钛人工听骨植入的效果。结果开放植入组术后平均气骨导差为15.72±11.18dB,气骨导差平均缩小17.45±5.23dB,听力重建成功率71.54%,明显优于开放未植入组(分别为22.80±14.68dB、12.80±14.68dB、22.97%)(均为P<0.05);完壁植入组术后平均气骨导差为8.13±5.37dB,气骨导差平均缩小26.85±11.03dB,听力重建成功率75.12%,明显优于完壁未植入组(分别为27.67±8.94dB、17.67±8.94dB、43.59%)(均为P<0.05)。结论慢性化脓性中耳炎患者行开放式、完壁式鼓室成形术中一期植入钛人工听骨均能有效提高听力。Objective To study the effects of titanic artificial ossicle replacement in canal wall-down and canal wall-up tympanoplasty for patients suffering from chronic otitis media.Methods A total of157cases(164ears)underwent canal wall-down and canal wall-up tympanoplasty at our hospital from Feburary2014to Feburary2016were retrospectively analyzed,in which50cases in canal wall down tympanoplasty with titanic ossicle replacement,49cases without replacement,42cases in canal wall-up tympanoplasty with titanic artificial ossicle replacement,and23cases without replacement.The average air bone gaps(ABG)before and3months after operations were recorded and the average reduced ABGs were compared between sub-groups to evaluate the effects of titanic artificial ossicle replacement.Results In the canal wall-down tympanoplasty group,the mean ABGs of3months after operations in the replacement subgroup was15.72±11.18dB,the reduced ABGs was17.45±5.23dB,and the improving rate for hearing was71.54%,statistically higher than the non-replacement subgroup(P<0.05).In the canal wall-up tympanoplasty group,the mean ABGs of3months after operations in the replacement subgroup was8.13±5.37dB,the reduced ABGs was26.85±11.03dB,the improving rate for hearing was75.12%,statistically higher than non-replacement subgroup(P<0.05).Conclusion The replacement of titanic artificial ossicle in both of canal wall-down and canal wall-up tympanoplasty is helpful to improve hearing.

关 键 词：钛听骨植入 鼓室成形术 

分 类 号：R764.44[医药卫生—耳鼻咽喉科]