钛质人工听小骨在开放式鼓室成形术中的疗效观察与应用体会

目的 探讨Ⅰ期钛质人工听小骨听力重建在慢性中耳炎和中耳胆脂瘤患者中的临床疗效及应用体会。 方法 回顾性分析行开放式鼓室成形术并接受Ⅰ期钛质人工听小骨听力重建的慢性中耳炎或中耳胆脂瘤患者65例临床资料,比较术前及术后1、3、6个月听力情况和气骨导差(ABG)。 结果 术后第1、3、6个月,纯音气导听阈均值(PTA)较术前降低,差异有统计学意义(P<0.05);术后6个月ABG均值较术前降低,差异具有统计学意义(P<0.05);术后ABG≤20 dB者达39耳(P<0.05)。 结论 开放式鼓室成形术加Ⅰ期钛质人工听小骨行听骨链重建治疗慢性中耳炎和中耳胆脂瘤能够有效提高患者的听力水平;选择适当的手术适应证、良好的手术技巧及围手术期处理是取得成功的保证。

Application of titanium ossicular replacement prosthesis in open mastoidectomy with tympanoplasty for ossicular chain reconstruction

Objective To explore the effects of using titanium ossicular replacement prosthesis in open mastoidectomy with ympanoplasty. Method From January 2013 to March 2015, 65 cases with chronic suppurative otitis media and middle ear cholesteatoma were treated with open mastoidectomy and tympanoplasty. Ossicular chains were reconstructed by partial ossicular replacement prosthesis(PORP)or total ossicular replacement prosthesis(TORP). The clinical data of these cases were retrospectively analyzed. The hearing threshold of air conduction and air bone gap(ABG)were compared before and 1,3,6 months after surgery. Results After 6 months of operation, the pure tone average(PTA)and averaged ABG of patients with chronic suppurative otitis media or middle ear cholesteatoma were dropped compared with those before surgery, with significant difference(P<0.05). There were 39 ears with an ABG lower than 20 dB after operation. Conclusion The effects of using titanium ossicular replacement prosthesis in open mastoidectomy with tmpanoplasty is satisfied for patients with chronic suppurative otitis media or middle ear cholesteatoma. The surgical indication and technique, as well as perioperative management, should be considered to ensure the success of operation.