经面神经后径路振动声桥圆窗植入术  

Round window implantation of vibrant soundbridge through a retrofacial approach

作　　者：李洁[1] 杨琳[2] 王丹妮[2] 任冉[2] 赵守琴[2] LI Jie;YANG Lin;WANG Danni;REN Ran;ZHAO Shouqin(Department of Otorhinolaryngology,Fuxing Hospital,Capital Medical University,Beijing,100038,China;Department of Otolarygology Head and Neck Surgery,Beijing Tongren Hospital,the Key Laboratory of Otolaryngology Head and Neck Surgery,Capital Medical University)

机构地区：[1]首都医科大学附属复兴医院耳鼻咽喉科,北京100038 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京市耳鼻咽喉科研究所,教育部耳鼻咽喉头颈科学重点实验室(首都医科大学)

出　　处：《临床耳鼻咽喉头颈外科杂志》2021年第11期1023-1027,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：北京市科委首都临床特色应用研究(No:Z171100001017079)。

摘　　要：目的:探讨在复杂先天性耳畸形患者中,经面神经后径路完成振动声桥(VSB)圆窗植入手术的可能性。方法:本研究回顾了4例先天性耳畸形患者资料,因面神经乳突段重度前移遮盖圆窗,致使无法经常规面隐窝径路植入VSB,后采用经面神经后径路暴露圆窗龛,顺利完成VSB圆窗植入术。结果:4例患者均经面神经后径路顺利植入VSB,术后VSB助听状态下的自由声场阈值及言语识别率均较术前明显改善,均未出现术中或术后并发症。结论:在圆窗振动成型术中,当面神经畸形遮盖圆窗,导致常规经面隐窝径路无法暴露圆窗龛时,可尝试经面神经后径路完成手术。Objective: To investigate the specific retrofacial approach for application of vibrant soundbridge(VSB) to the round window(RW) in patients with complex congenital ear malformation. Methods: The clinical information of four patients with congenital ear malformation were retrospectively analyzed. VSB were implanted unilaterally in these four patients via a retrofacial approach. During the operation, it is difficult to reach the RW via a classic posterior tympanotomy pathway, due to the mastoid portion of FN positioned anteriorly severely. So the round window niche was identified through a retrofacial pathway and the round window vibroplasty was completed. Results: All four patients received the round window vibroplasty successfully via retrofacial approach. Satisfied auditory benefit were confirmed after surgery. Compared with the preoperative data, clear improvements in both hearing threshold and the speech discrimination score were confirmed after VSB activation. Neither intraoperative nor postoperative surgical complications was observed in all patients.Conclusion: During the round window vibroplasty, when it was unable to access the RW through the classic facial recess pathway due to the aberrant facial nerve, the retrofacial approach could be a valid and feasible alternative approach.

关 键 词：耳畸形 面神经后 径路 声桥 植入 

分 类 号：R764.7[医药卫生—耳鼻咽喉科]