可调节钛金属部分听骨赝复物在Ⅱ型鼓室成形术中的应用  

Application of adjustable titanium partial ossicular replacement prosthesis in type Ⅱ tympanoplasty

作　　者：林颖[1] 于锋 张浩亮[1] 刘炜 黄佳丽 LIN Ying;YU Feng;ZHANG Hao-liang;LIU Wei;HUANG Jia-li(Department of Otolaryngology Head and Neck Surgery,the Twelfth People’s Hospital Affiliated to Guangzhou Medical University,Guangzhou 510620,China;Department of Otolaryngology Head and Neck Surgery,Guangzhou Red Cross Hospital,Guangzhou 510220,China)

机构地区：[1]广州医科大学附属第十二人民医院耳鼻咽喉头颈外科,广东广州510620 [2]广州市红十字会医院耳鼻咽喉头颈外科,广东广州510220

出　　处：《中国耳鼻咽喉颅底外科杂志》2020年第1期40-43,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：广州市科技计划项目(201704020178)

摘　　要：目的探讨可调节部分钛听骨在Ⅱ型鼓室成形术听力重建中的疗效。方法回顾分析95例慢性化脓性中耳炎患者(均为单耳发病),随机分为两组,实验组(47耳):应用可调节钛金属部分听骨赝复物(PORP)行开放式乳突根治术+Ⅱ型鼓室成形术;对照组(48耳):应用固定型钛听骨PORP重建听骨链。术后所有患者均随访1年以上,术后3个月、1年时分别对比两组的手术前后听力变化(0.5、1、2、4 kHz)及有效率。结果①实验组中1耳钛听骨移位;1耳筋膜裂缝,纳入听力研究45耳。一期手术成功率为95.7%(45/47),对照组中2耳钛听骨移位、2耳筋膜裂缝,纳入听力研究44耳。一期手术成功率为91.7%(44/48);②实验组与对照组比较,术后3个月气骨导差比较,差异具有统计学意义(P<0.05);术后1年气骨导差比较,差异无统计学意义(P>0.05);③实验组与对照组有效率比较,差异无统计学意义(P>0.05)。结论可调节钛听骨应用于听骨链重建有独特优越性,术后3个月听力恢复优于固定型钛听骨,为中耳传音材料提供新的选择。Objective To study the effect of adjustable titanium partial ossicular replacement prosthesis(PORP) in type Ⅱ tympanoplasty.Methods Clinical data of 95 chronic suppurative otitis media patients received radical mastoidectomy combined with type Ⅱ tympanoplasty with adjustable titanium PORP(experimental group, n=47) or fixed titanium PORP(control group, n=48) were analyzed retrospectively. The audiometric changes [air-bone gap(ABG) at 0.5,1,2,4 kHz] and effective rate at 3 months and one year after surgery were compared.Results ①45 cases in the experimental group succeeded in one-stage surgery with a successful rate of 95.7%(45/47)(2 failure cases included one with PORP displacement and one with fascia fissure). 44 cases in the control group succeeded with a successful rate of 91.7%(44/48)(Failure cases included 2 with PORP displacement and 2 with fascia fissure). A total of 89 cases had audiometric data available for analysis. ②The difference of ABG between the two groups at 3 months was statistically significant(P<0.05), but insignificant(P>0.05) at one year postoperatively.③The effective rate between the two groups was statistically insignificant(P>0.05).Conclusions Adjustable titanium PORP can provide hearing outcomes superior to fixed one at 3 months after ossiculoplasty. It can be selected in clinic to improve the function of middle ear transmission.

关 键 词：慢性化脓性中耳炎 可调节钛听骨 固定型钛听骨 部分听骨赝复物 听骨链重建 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]