不同听骨链重建术的临床效果及安全性分析  

Comparison and safety analysis of different ossicular chain reconstruction in endoscopic otoscopy

作　　者：韩闯举 林书会 李健 罗东方 张选桃 佗亚娟 HAN Chuangju;LIN Shuhui;LI Jian;LUO Dongfang;ZHANG Xuantao;TUO Yajuan(Department of ENT,the 948th Hospital of PLA,Wusu 833000,China)

机构地区：[1]陆军第九四八医院五官科,新疆乌苏833000

出　　处：《中国耳鼻咽喉颅底外科杂志》2025年第1期82-85,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的比较自体听小骨组织与钛合金人工听小骨听骨链重建术(OCR)的临床效果及安全性。方法收集2018年1月—2023年1月住院治疗的慢性中耳炎(COM)患者78例,均行鼓室成形术及OCR治疗,依据OCR材料不同分为自体组(41例)与人工组(37例)。自体组予以自体听小骨组织OCR治疗,人工组予以钛合金人工听小骨OCR治疗。统计两组手术指标、并发症发生情况、术后1年内复发情况,比较术前、术后6个月不同频率段气导听力、骨导听力、气-骨导差(ABG)水平。结果自体组手术时间长于人工组,手术费用低于人工组(P<0.05)。术后6个月不同频率段(0.5、1、2 kHz)两组气导听力、ABG均较术前降低(P<0.05),而术后6个月自体组、人工组不同频率段气导听力、骨导听力、ABG水平比较,差异无统计学意义(P>0.05)。自体组并发症发生率低于人工组(P<0.05),但两组1年内复发率比较无差异(P>0.05)。结论COM患者OCR术式中,采用自体听小骨组织植入、钛合金人工听小骨植入均可有效改善患者听力水平,相较而言,后者手术耗时短,而前者费用及并发症发生率低。Objective To compare the efficacy and safety of autologous ossicular bone and titanium alloy ossicular chain reconstruction(OCR)in endoscopic otoscopy.Methods It was collected for data of 78 patients with chronic otitis media(COM)in our hospital from January 2018 to January 2023.All patients underwent tympanoplasty and OCR treatment,who were divided into autogenous group(41 cases)and artificial group(37 cases)according to different OCR materials.The autologous group was treated with OCR of autologous auditory ossicles,and the artificial group was treated with OCR of titanium alloy auditory ossicles.It was analyzed for the surgical indexes,complications and recurrence within 1 year after surgery between the two groups.It was compared for the levels of air-conduction hearing,bone-conduction hearing and air-bone gap(ABG)in different frequency segments before surgery and 6 months after surgery.Results The operation time of autologous group was longer than that of artificial group,and the operation cost was lower than that of artificial group(P<0.05).The air conduction hearing and ABG of the two groups in different frequency segments(0.5,1,2 kHz)were decreased 6 months after operation compared with those before operation(P<0.05).However,there was no significant difference in air conduction hearing,bone conduction hearing and ABG level between different frequency segments of the autologous group and the artificial group 6 months after surgery(P>0.05).The complication rate of autologous group was lower than that of artificial group(P<0.05),but there was no difference in the recurrence rate within 1 year between the two groups(P>0.05).Conclusions The implantations of the autologous auditory ossicle tissue and the titanium alloy artificial auditory ossicle can effectively improve the hearing level of patients in the OCR operation for COM patients.Compared with the autologous group,the operation time of the artificial group is short,while the cost and complication rate of the autologous group are low.

关 键 词：慢性中耳炎 听骨链重建术 自体听小骨组织 钛合金人工听小骨 听力 并发症 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]