钛合金人工听骨和自体听骨在听骨链重建中的疗效观察

目的：分析钛合金人工听骨植入和自体听骨植入在慢性中耳炎听骨链重建的价值。方法：于2017年5月~2020年2月在我院行听骨链重建术的经纳入排除后收纳的慢性中耳炎患者中随机选取60例，按照随机、双盲的方法分为对照组30例及研究组30例。所有患者均行听骨链重建术，其中，对照组患者慢性中耳炎患者听骨链重建术中给予钛合金人工听骨植入，研究组患者给予自体听骨植入。比较两组患者的手术费用及手术时间。分别于术前、术后3月、6月、12月时采用纯音听阈检测方法检测两组患者纯音听力情况。对两组听力改善情况、术后不良反应发生率及复发情况进行对比。结果：研究组患者手术费用较对照组明显减少，手术时间较对照组明显延长，不良反应发生率及复发率较对照组明显降低（P<0.05）。与术前比较，术后两组患者气导听力、气骨导差均明显降低（P<0.05），随着术后时间的延长，患者气导听力气骨导差均逐渐降低。术前与术后各时间点比较两组患者骨导听力无明显变化（P>0.05）。两组患者术前及术后各时间点各指标均无明显差异（P>0.05）。与对照组比较，研究组患者听力改善有效率有所降低，但两组比较无明显差异（P>0.05）。结论：钛合金人工听骨植入和自体听骨植入治疗慢性中耳炎听骨链重建均具有一定价值，其中钛合金人工听骨植入手术所需时间较短，而自体听骨植入不良反应、复发率及费用较低。

Comparative study on the effects between self-incur and Titanium alloy artificial ossicle replacement pros-thesis in reconstruction of ossicular chain

Objective: To analyze the value of titanium alloy artificial ossicular implantation and autogenous ossicular implantation in bone chain reconstruction of chronic suppurative otitis media.Methods: From May 2017 to February 2020, 60 patients with chronic suppurative otitis media who underwent bone chain reconstruction in our hospital after inclusion and exclusion were randomly selected and divided into control group (n = 30) and study group (n = 30) according to the random and double-blind method. All patients underwent bone chain reconstruction for chronic suppurative otitis media,The control group was given titanium alloy artificial auditory bone implantation during bone chain reconstruction for chronic suppurative otitis media, and the study group was given autologous auditory bone implantation. The operation cost and operation time of the two groups were compared. Pure tone audiometry was used to detect the pure tone audiometry before operation, 3 months, 6 months and 12 months after operation. The hearing improvement, incidence of postoperative adverse reactions and recurrence were compared between the two groups.Results: Compared with the control group, the operation cost of the study group was significantly reduced, the operation time was significantly prolonged, and the incidence of adverse reactions and recurrence rate of the study group were significantly reduced (P < 0.05).Compared with the preoperative, the difference of the air conduction hearing and the difference of the air bone conduction in the two groups were significantly reduced (P < 0.05). With the prolongation of the postoperative time, the difference of the air-guided hearing was decreased gradually. There was no significant change in bone conduction hearing between the two groups before and after operation (P > 0.05). There was no significant difference in the indexes of the two groups before and after operation (P > 0.05). Compared with the control group, the hearing improvement efficiency of the study group was decreased, but there was no significant difference between the two groups (P > 0.05).conclusion: Titanium alloy artificial ossicular implantation and autogenous ossicular implantation have certain value in the treatment of chronic suppurative otitis media. Titanium alloy artificial ossicular implantation takes a shorter time, while autogenous ossicular implantation has lower adverse reactions and recurrence rate.