自体乳突骨皮质塑形听骨假体在听骨链重建术中的应用  

Application of autogenous mastoid cortex bone in ossiculoplasty

作　　者：邓华 祝晓宇 DENG Hua;ZHU Xiaoyu(Department of Otorhinolaryngoloy,The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang,Guizhou 550001,China)

机构地区：[1]贵州中医药大学第一附属医院耳鼻咽喉科

出　　处：《现代医药卫生》2019年第22期3451-3454,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨以自体乳突骨皮质塑形制作听骨假体在听骨链重建术中的应用价值及疗效。方法采用回顾性研究方法,选取2014-2017年该院收治的慢性化脓性中耳炎/中耳胆脂瘤患者22例(23耳)作为研究对象,应用自体乳突骨皮质塑形制作听骨假体重建听骨链,术后随访6个月,分析患者纯音听阈值的改善情况。结果22例(23耳)患者均获得干耳。术后6个月语频段气导听阈值小于或等于30 dBHL者5耳[21.74%(5/23)];术后语频段气导听阈值较术前降低10 dBHL,但听阈值大于30 dBHL者17耳[73.91%(17/23)];术后语频段气导听阈值与术前比较无变化者1耳[4.35%(1/23)]。术后语频段气骨导差值小于20 dBHL者15耳,听骨链重建成功率为65.22%(15/23)。结论自体乳突骨皮质塑形制作而成的听骨假体生物相容性好,取材方便,在听骨链重建术中应用自体乳突骨皮质重建听骨链可有效提高患耳听力,节省医疗费用。Objective To investigate the clinical value and effect of ossicular prosthesis made of autogenous mastoid cortical bone in ossicular chain reconstruction.Methods A total of 22 cases(23 ears)of patients with chronic suppurative otitis media/cholesteatoma of the middle ear admitted to the hospital from 2014 to 2017 were selected as the study subjects.All patients were treated with autogenous mastoid cortex bone block to make ossicular prosthesis for ossicular chain reconstruction.After 6 months,the improvement of pure tone threshold was analyzed.Results A total of 22 cases(23 ears)achieved dry ears.6 months postoperation,5 ears of patients with speech frequency band airway hearing threshold less than or equal to 30 dBHL[21.74%(5/23)].Postoperation,the auditory threshold of speech band ventilation was 10 dB lower than that preoperation,but the auditory threshold was greater than 30 dBHL in 17 ears[73.91%(17/23)].One ear of patients with no change in postoperative speech frequency band airway hearing threshold compared with that before surgery[4.35%(1/23)].The success rate of ossicular chain reconstruction was[65.22%(15/23)]in 15 ears of patients with speech frequency pairbone conduction difference less than 20 dBHL.Conclusion The ossicular prosthesis made of autogenous mastoid cortical bone has good biocompatibility and is easy to obtain materials.The reconstruction of ossicular chain with autogenous mastoid cortical bone can effectively improve the hearing of the affected ear and save medical expenses.

关 键 词：乳突/移植 移植 自体 听小骨假体 镫骨外科手术 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]