两种不同路径人工镫骨植入术治疗耳硬化症的效果比较  

Comparison of efficacy of artificial stapes implantation with two different approaches for patients with otosclerosis

作　　者：丁吉女[1] 刘锡蒙 黄佳诺 田如如 王璐琦 解道宇 DING Jinyu;LIU Ximeng;HUANG Jianuo;TIAN Ruru;WANG Luqi;XIE Daoyu(Department of Otolaryngology,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China;不详)

机构地区：[1]杭州师范大学附属医院耳鼻咽喉科,310015

出　　处：《浙江医学》2025年第1期76-79,共4页Zhejiang Medical Journal

基　　金：杭州市生物医药和健康产业发展扶持科技专项(2022WJC037)。

摘　　要：目的 比较耳内镜下手钻镫骨底板开窗人工镫骨植入术与显微镜下CO_(2)激光辅助镫骨底板开窗人工镫骨植入术治疗耳硬化症的效果。方法 回顾性选取2014年4月至2023年12月杭州师范大学附属医院收治的耳硬化症患者72例。其中35例患者行耳内镜下手钻镫骨底板开窗人工镫骨植入术,为耳内镜组;另37例患者行显微镜下CO_(2)激光辅助镫骨底板开窗人工镫骨植入术,为显微镜组。观察并比较两组患者手术时间、病变耳术后听阈(术后第6个月评估)、术后严重并发症发生情况(如面瘫、眩晕、味觉变化等)。结果 两组患者手术时间、病变耳术后听阈比较差异均无统计学意义[(66.10±12.65)min比(62.20±19.38)min、(40.69±10.27)dB比(41.36±11.87)dB,均P>0.05];耳内镜组患者严重并发症发生率低于显微镜组,差异有统计学意义(2.86%比8.11%,P<0.05)。结论 上述两种不同路径下的人工镫骨植入术治疗耳硬化症效果相近,但耳内镜下手术术后发生严重并发症的风险更小。Objective To compare the efficacy of artificial stapes implantation with otoendoscopic stapes floor fenestration or CO_(2) laser-assisted and microscopic stapes floor fenestration for patients with otosclerosis.Methods Seventytwo patients with otosclerosis admitted to the Affiliated Hospital of Hangzhou Normal University from April 2014 to December 2023 were included in the study.Among them,35 cases underwent artificial stapedial implantation with otoendoscopic stapes floor fenestration(endoscopic group)and 37 cases with CO_(2) laser-assisted and microscopic stapes floor fenestration(microscopic group).The operation time,postoperative hearing threshold 6 months after surgery,and the occurrence of serious postoperative complications including facial paralysis,vertigo,taste change,etc.were compared between the two groups.Results There was no significant difference in surgical time and postoperative hearing threshold between the two groups of patients[(66.10±12.65)min vs.(62.20±19.38)min,and(40.69±10.27)dB vs.(41.36±11.87)dB,both P>0.05].The incidence of severe complications in the endoscopic group was lower than that in the microscopic group(2.86%vs.8.11%,P<0.05).Conclusion The therapeutic effects of artificial stapes implantation with two different approaches are similar for patients with otosclerosis,but endoscopic surgery has a lower risk of serious postoperative complications compared to microscopic surgery.

关 键 词：耳硬化症 耳内镜 显微镜 人工镫骨 手术 激光 

分 类 号：R47[医药卫生—护理学]