晚期耳硬化症的治疗效果

目的探讨镫骨手术对晚期耳硬化症的治疗效果。方法随机抽取300例1970年至1999年间的耳硬化症手术病例，对符合晚期耳硬化症标准500—2000Hz骨导听阈（听力级，下同）均值≥40dB，气导听阈均值≥70dB的混合性聋]的68例（77耳）进行回顾性分析。结果68例（77耳）术后，500—2000Hz纯音平均听阈：气导（听力级，下同）由术前的77．32dB减至53．70dB，提高23．62dB；71耳（92．21％）气导提高≥10dB，其中46耳（59．74％）气骨导差闭合。500～4000Hz纯音平均听阈：气导由79.01dB减至58．23dB，提高20。78dB；68耳（88．31％）气导提高≥10dB，其中32耳（41．56％）气骨导差≤10dB（闭合）。随访5～25年，听力稳定的有67耳，听力下降4耳（均为镫骨提高术患者，再次手术后听力均有提高），听力较术后进一步提高的有28耳。结论镫骨手术是治疗耳硬化症的有效手段，也是治疗晚期耳硬化症或极晚期耳硬化症的有效方法之一。镫骨手术对改善晚期耳硬化症或极晚期耳硬化症患者的听力有较大帮助。

Results of surgical treatment for advanced otosclerosis

OBJECTIVE: To assess the effect of stapes surgery on advanced otosclerosis (AO). METHODS: In 300 cases randomly collected of otosclerosis in 1970 to 1999, 68 cases (77ears) were selected for retrospective analysis, which met the criteria of advanced otosclerosis (mixed deafness, with bone-conduction levels exceeding 40 dB and air-conduction levels exceeding 70 dB in 500 - 2000 Hz). RESULTS: The air-conduction of sixty-eight cases (77 ears) were from 77.32 dB to 53.7 dB (500-2000 Hz) after operation, mean decreased 23.62 dB. Of 71 ears (92.21%) obtained air-conduction improved over 10 dB, of 46 ears (59.74%) gained A-B Gap closure in 10 dB. Air-conduction were from 79.01 dB to 58.23 dB (500 - 4000 Hz) after operation and mean decreased 20.78 dB. Of 68 ears (88.31%) obtained air-conduction improved over 10 dB, of 32 ears (41.56%) gained A-B gap closure in 10 dB. After followed up 5-25 years, of 67 ears were retained stabilization, of 28 ears obtained more improve than postoperation. But 4 ears had drop (all was stapes-elevation and re-improvement after them was reviewed). CONCLUSION: Stapes surgery is effective operation to cured otosclerosis, advanced otosclerosis or far-advanced otosclerosis had greater help to improved hearing.