耳内镜与显微镜在先天性中耳畸形手术中的应用  

Application of endoscopic and microscopic ear surgery for congenital middle ear malformation

作　　者：刘娅 王辉兵 赵丹珩 朱玉华 王方园 侯昭晖 LIU Ya;WANG Huibing;ZHAO Danheng;ZHU Yuhua;WANG Fangyuan;HOU Zhaohui(Senior Department of Otolaryngology-Head&Neck Surgery,the Sixth Medical Center of PLA General Hospital,National Clinical Research Center for Otolaryngologic Diseases,State Key Lab of Hearing Science,Ministry of Education,China,Beijing Key Lab of Hearing Impairment Prevention and Treatment,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部、国家耳鼻咽喉疾病临床医学研究中心、聋病教育部重点实验室、聋病防治北京市重点实验室,北京100048

出　　处：《中国眼耳鼻喉科杂志》2023年第5期391-393,410,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：中国人民解放军总医院第六医学中心创新培育基金资助项目(CXPY2019)。

摘　　要：目的对比耳内镜和显微镜在中耳畸形手术中的应用效果。方法回顾收集2020年4月—2022年11月在我科手术治疗的先天性中耳畸形患者18例(21耳),其中11耳采用耳内镜手术,10耳采用显微镜手术。结果耳内镜组平均手术时间为119 min;显微镜组的平均手术时间为199 min,排除3耳合并外耳道狭窄手术后的平均手术时间为188 min,较耳内镜手术的时间长,差异具有统计学意义(P=0.027)。耳内镜组术前气骨导差为(37.7±10.4)dB,术后为(20.3±9.5)dB,较术前缩小(16.3±17.8)dB;显微镜组术前气骨导差为(40.2±10.6)dB,术后为(20.0±11.2)dB,较术前缩小(14.5±19.0)dB,U检验显示2组患者的手术前后听力变化差异无统计学意义(P>0.05)。结论耳内镜和显微镜在先天性中耳畸形手术中对听力效果的改善没有明显区别,但耳内镜手术时间明显短于同类型显微镜手术。Objective To compare the effects of endoscopic and microscopic ear surgery for congenital middle ear malformation.Methods Data of 18 patients(21 ears)have been collected retrospectively,who came to our department during April 2020 and November 2022.Eleven ears had been operated with endoscope and 10 ears with microscope.Result The duration of the endoscopic group was 119 minutes averagely,and it was 199 minutes in the microscopic group averagely.If the 3 ears with ear canal plasty were excluded,the mean duration of the microscopic group was 188 minutes.The difference between the 2 groups was statistically significant(P=0.027).The air-bone gap of endoscopic group was(37.7±10.4)dB preoperatively and(20.3±9.5)dB postoperatively with the reduction of(16.3±17.8)dB.The air-bone gap of microscopic group was(40.2±10.6)dB preoperatively and(20.0±11.2)dB postoperatively with the reduction of(14.5±19.0)dB.However,there was no significant difference between the two groups in hearing levels(P>0.05).Conclusions Although there was no difference of hearing improvement between endoscopic and microscopic group,the duration of endoscopic surgery was statistically shorter than the microscopic surgery.

关 键 词：耳内镜手术 显微镜手术 中耳畸形 听力 人工听骨 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]