不同镫骨手术治疗鼓室硬化症的远期疗效

目的研究不同镫骨手术治疗鼓室硬化症的远期疗效。方法将医院耳鼻喉科2013年2月至2018年2月收治的100例(120耳)鼓室硬化症患者依据不同镫骨手术治疗方法分为A组(25例)、B组(39例)和C组(36例),A组给予镫骨撼动术治疗,B组给予镫骨切除术治疗,C组给予镫骨钻孔活塞术治疗。评估三组患者不同随访时间的气导听力改善情况及气导平均听阈分布情况。结果随访0.5~<1年、1~<2年、2~<5年,C组的气导听力改善率均显著高于A、B组,A组的气导听力改善率均显著低于B组,差异具有统计学意义(P<0.05)。三组随访0.5~<1年、1~<2年、2~<5年的气导平均听阈范围<15dB的患者占比组内比较,差异不具有统计学意义(P>0.05);随访0.5~<1年、1~<2年、2~<5年,三组中气导平均听阈范围<15dB的患者占比组间比较,差异不具有统计学意义(P>0.05)。结论镫骨手术是治疗鼓室硬化症的有效手段,能够保证临床治疗的安全性,且患者术后5年内的远期疗效较优,在临床治疗中需要根据患者的个体差异选取适合的手术方式,促进患者远期疗效的提升。

Long-term efficacy of different stapes surgery in the treatment of tympanosclerosis

Objective To study the long-term efficacy of different stapes surgery in the treatment of tympanosclerosis.Methods A total of 100 patients(120 ears) with tympanosclerosis admitted in otolaryngology department of the hospital from February 2013 to February 2018 were divided into group A(25 cases), group B(39 cases) and group C(36 cases)by different stapes surgure methods. The group A was treated with stapediolysis, the group B was treated with stapedectomy and the group C was treated with stapes drilling piston operation. The improvement of air conduction hearing and the average auditory threshold of air conduction in the three groups at different follow-up time were evaluated. Results Following up for 0.5-<1 year, 1-<2 years and 2-<5 years, the improvement rates of air conduction hearing in the group C were significantly higher than those in the groups A and B, and the improvement rates of air conduction hearing in the group A were significantly lower than those in the group B, the differences were statistically significant(P<0.05). There were no significant differences in the proportions of patients whose average auditory threshold of air conduction <15 dB during the follow-up of 0.5-<1 year, 1-<2 years and 2-<5 years of the three groups compared within the group(P >0.05). Following up for 0.5-<1 year, 1-<2 years and 2-<5 years, there were no significant differences in the proportions of patients whose average auditory threshold of air conduction <15 dB among the three groups(P>0.05). Conclusion Stapes surgery is an effective method for tympanosclerosis, which can ensure the safety of clinical treatment, and the long-term effect of patients within 5 years after surgery is better. In clinical treatment, it is necessary to select appropriate surgical methods according to the individual differences of patients, so as to promote the long-term effect of patients.