锤骨前庭桥接术应用于听骨链重建的远期效果分析  

The long term effect of malleostapedotomy in ossicular chain reconstruction

作　　者：王晓茜[1] 黄宏明[1] 葛润梅 黄艳[1] 许咪咪[1] 汪菊萍[1] 黄东华 黄韵烨 莫烨菲 林晓德 吴佩娜[1] WANG Xiaoqian;HUANG Hongming;GE Runmei;HUANG Yan;XU Mimi;WANG Juping;HUANG Donghua;HUANG Yunye;MO Yefei;LIN Xiaode;WU Peina(Department of Otorhinolaryngology,Guangdong Academy of Medical Sciences&Guangdong Provincial People's Hospital,Guangzhou,510080,China)

机构地区：[1]广东省医学科学院广东省人民医院耳鼻咽喉科,广州510080

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第10期884-888,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析锤骨前庭桥接术(MT)应用于听骨链重建的远期效果。方法:回顾性分析应用MT技术重建中耳传声功能并获得远期随访的11例(12耳)患者资料,统计术前、术后1周和术后≥1年的听力结果,根据术中发现、手术并发症及术后听力效果,探讨此术式的适应证,评估其远期安全性和有效性。结果:11例(12耳)中,鼓室硬化1例(1耳),先天性听骨链畸形3例(4耳),耳硬化症5例(5耳),局灶性中耳胆脂瘤2例(2耳)。所有患者术后2周内均无骨导听力下降(骨导损失超过10dB);4例术后短暂眩晕,平均3d缓解;2例局灶性中耳胆脂瘤患者无复发。随访1~6年,全部患者气导改善显著,无骨导下降,气骨导差术前与术后的差异有统计学意义(P<0.05)。结论:在严格掌握手术适应证的前提下,MT远期效果安全有效,适用于多种原因导致的伴有锤砧传声功能障碍的镫骨或底板固定的听骨链重建。Objective:To analysis the long-term outcomes of ossicular chain reconstruction using the malleostapedotomy(MT).Method:A total of 11patients(12ears)underwent MT and their hearing levels were measured prior to surgery,1week and more than 1year after surgery.The indications of MT were discussed and its safety and efficacy were evaluated in terms of the intra-operative findings,post-operative hearing and complications.Result:Among 11patients(12ears),there were 1patient(1ear)with tympanosclerosis,3patients(4ears)with ossicular chain deformity,5patients(5ears)with otosclerosis and 2patients(2ears)with localized cholesteatoma of the middle ear.No cases of bone conduction hearing loss(more than 10dB)were observed within 2weeks after surgery while four patients suffered from short-term vertigo with an average remission duration of 3days.And no recurrence was found in the two patients with cholesteatoma.After a follow-up of 1-6years,we found a remarkable improvement of air conduction without bone conduction loss in all patients and there was a significant difference between preoperative and post-operative air-bone gap(P<0.05).Conclusion:With a strict selection according to the indications,MT showes safe and effective long-term outcomes and is proved to be applicable in ossicular chain reconstruction in the cases of fixation of the stapes footplate accompanied with malleus/incus mobility disorder by various causes.

关 键 词：锤骨前庭桥接术 镫骨手术 耳硬化症 听骨链重建 远期效果 

分 类 号：R764.32[医药卫生—耳鼻咽喉科]