单纯性先天性听骨链畸形的听力学特征及手术效果  

Audiological characteristics and efficacy of surgery in patients with simple congenital malformation of ossicular chain

作　　者：戴智梅 冯叶开 杨海弟[2] DAI Zhimei;FENG Yekai;YANG Haidi(Department of Otolaryngology,Zengcheng Civil Hospital,Guangzhou,Guangdong,511300,China;Department of Otolaryngology,Sun Yat-sen Memorial Hospital,Guangzhou,Guangdong,510120,China)

机构地区：[1]增城区人民医院耳鼻咽喉科,广东广州511300 [2]中山大学孙逸仙纪念医院耳鼻咽喉科,广东广州510120

出　　处：《中国耳鼻咽喉头颈外科》2020年第5期248-251,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的分析单纯性先天性听骨链畸形听力学特征及手术效果。方法回顾性分析85例(91耳)手术确诊为先天性听骨链畸形患者,收集患者临床资料及纯音听阈结果,统计术中所见各听小骨畸形,分析术前-术后纯音听阈结果。结果根据镫骨底板固定及活动分组,术前固定组与活动组气导、骨导和气骨导差(air-bone gap,ABG)各频率间比较,差异无统计学意义(P均>0.05);术后固定组与活动组ABG在低频区比较,差异有统计学意义(t=2.189,P<0.05)。以ABG≤20 dB作为手术成功指标,60耳中有44耳(72.41%)术后ABG≤20 dB。结论单纯性先天性听骨链畸形患者,无论镫骨底板固定与否,气导均表现为中度听力损失,可通过手术方式重建听骨链获得较好效果,术后镫骨底板活动组较镫骨底板固定组效果佳。OBJECTIVE To analyze the audiological characteristics and surgical efficacy of simple congenital ossicular chain malformation.METHODS The clinical data of 85 patients(91 ears)with congenital malformation of ossicular chain underwent surgery were retrospective analyzed.The auditory ossicular deformities were recorded during the operation,and the results of pure tone hearing threshold before and after operation were analyzed.RESULTS Two groups were divided according to whether the stapes footplate was fixed or not.There were no significant differences in air conduction,bone conduction and air-bone gap(ABG)at various frequencies between the two groups(P>0.05),but there was significant difference in ABG at the low frequency region between the two groups after operation.Taking ABG≤20 dB as the index of operation success,44 ears(72.41%)of the 60 ears had postoperative ABG≤20 dB.CONCLUSION In patients with simple congenital malformation of ossicular chain,whether or not the stapes footplate is fixed,the air conduction presents moderate hearing loss,and the ossicular chain reconstruction can get good results.The surgical outcome in patients with movable stapes footplate before operation was better than that in patients with fixed stapes footplates.

关 键 词：听小骨 畸形 听力学 内窥镜检查 耳外科手术 

分 类 号：R764[医药卫生—耳鼻咽喉科]