人工听骨植入前后听力学分析及相关因素研究

目的 对比观察传导性耳聋患者采用人工听骨行听骨链重建手术前后的听力学改变，并对影响听力提高的相关因素进行分析探讨。方法 采用人工听骨赝复物重建听骨链行鼓室成形术46例。植入人工听骨材料分别采用美敦力多孔聚乙烯听骨赝复物或德国宾格产钛质人工听骨。赝复体的高度为所测量的镫骨头与锤骨柄之间的距离，应用全听骨赝复物(TORP)时，则为所测得的镫骨底板与锤骨柄之间的距离。鼓膜修补材料取耳屏软骨膜或颞肌筋膜片，分别采用夹层法、外置及内置方法进行修补。对比观察手术前后听力改善情况。结果 对施行该手术的患者进行随访6～67个月，所有患者鼓膜修补愈合良好，听力提高有效率78.7%，没有发生排异反应和病变复发。结论 应用人工听骨赝复物对传导性耳聋患者重建听骨链行鼓室成形术安全有效，术后听力显著提高，并可避免佩带助听器所带来的诸多不便。

Audiological analysis before and after artificial auditory ossicle implantation

Objective To compare the hearing changes in the patients with conductive deafness before and after ossicular chain reconstruction using artificial auditory ossicle, and analyze related factors affecting the improvement of hearing. Methods The efficacy of ossicular reconstruction with ossicular replacement prosthesis or Titanium artificial auditory ossicle was reviewed in 46 patients. Prosthetic height was the distance between capitulum stapedis and malleus handle. Tympanic membrane was repaired by sandwich method, overlay method or underlay method with autologous antilobium perichondrium or temporalis fascia. Results During the 6-to 67-month follow-up, tympanic membrane healed well in all the patients. The efficiency of hearing improvement was 78.7% and there was no rejection or recurrence. Conclusion The application of ossicular chain reconstruction using ossicular replacement prosthesis in the patients with conductive deafness is safe and effective. The postoperative hearing improvement is significant and the inconvenience of hearing aids is avoided.