比较不同材料人工听骨听力重建术

目的探讨中耳炎手术I期听骨链重建的合适材料和术式。方法 2005年10月～2008年10月在北京同仁医院耳鼻咽喉头颈外科住院手术治疗慢性化脓性中耳炎480耳作为研究对象,回顾性分析480例（耳）慢性化脓性中耳炎患者的听骨链重建手术所见及术后效果。对听骨链重建术效果的影响因素进行分析讨论。对慢性化脓性中耳炎患者的患病时间以及纯音听力测试手术前、后骨气导差进行比较。480例患者的手术方式有3种：开放式听骨链重建术、联合进路听骨链重建术和鼓室探查听骨链重建术。结果 3种手术方式术后听力效果无显著差异。按不同重建方式及不同听骨材料进行分类,镫骨完整病例的术后骨气导差≤20dB者中,钛金属听小骨占33%,自体听骨占30%,陶瓷骨占20%;术后骨气导差21～30dB者中,钛金属听小骨占59%,自体听骨占59%,陶瓷骨占37%。镫骨上部不完整的病例中,术后骨气导差≤20dB者中,钛金属听小骨占25%,自体听骨占13%,陶瓷骨占11%。术后骨气导差在21～30dB者中,钛金属听小骨占48%,自体听骨占47%,陶瓷骨占43%。结论手术方式对术后效果无影响,不同听骨材料及不同植入方式对听力效果有影响。

Discussion of influencing factors on effect of ossicular chain reconstruction

OBJECTIVE To discuss the best material and surgery style of synchronal ossicular chain reconstruction for chronic suppurative otitis media.METHODS 480 patients with chronic suppurative otitis media were selected at otolaryngology head and neck surgery department in Beijing Tongren Hospital from October 2005 to October 2008.The process and postoperative effect of ossicular chain reconstruction in these patients were reviewed and analyzed.The influencing factors of ossicle chain reconstruction were analyzed S...