山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (3): 66-70.doi: 10.6040/j.issn.1673-3770.1.2019.005

• 论著 • 上一篇    下一篇

钛人工听骨在I期乳突切开+鼓室成形术中应用的短期疗效观察

林伟1,2,朱冬超2,陈智斌1()   

  1. 1. 南京医科大学第一附属医院 江苏省人民医院耳鼻咽喉科,江苏 南京 210029
    2. 南京市六合区人民医院耳鼻咽喉科,江苏 南京 211500
  • 收稿日期:2019-01-01 修回日期:2019-05-05 出版日期:2019-05-20 发布日期:2019-08-07
  • 通讯作者: 陈智斌 E-mail:chenzhibin@jsph.org.cn

Short-term effects of artificial titanium auditory ossicles in stage I mastoidectomy and tympanoplasty

Wei LIN1,2,Dongchao ZHU2,Zhibin CHEN1()   

  1. 1. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
    2. Department of Otorhinolaryngology, Nanjing Liuhe District People's Hospital, Nanjing 211500, Jiangsu, China
  • Received:2019-01-01 Revised:2019-05-05 Online:2019-05-20 Published:2019-08-07
  • Contact: Zhibin CHEN E-mail:chenzhibin@jsph.org.cn

摘要: 目的

探讨钛人工听骨用于I期乳突切开和鼓室成形术中的短期疗效。

方法

以2013年 1月~2017年6月江苏省人民医院耳鼻咽喉科80例(81耳)行I期乳突切开+鼓室成形术中应用钛人工听骨的患者为研究对象,按手术方式分为完壁式乳突切开+鼓室成形术并I期人工听骨植入(完壁植入组31耳);开放式乳突切开+鼓室成形术并I期人工听骨植入(开放植入组50耳)。对比观察两组术后近期疗效。

结果

完壁植入组术后平均气骨导差为 (18.65±9.46) dB,听力重建成功率83.87%;开放植入组术后平均气骨导差为(19.90±9.42) dB,听力重建成功率 62.00%;两组手术前后气导及气骨导差(ABG)平均值比较差异均有统计学意义(P <0.05)。两组之间术后听力重建成功率比较差异有统计学意义(P <0.05)。

结论

开放式、完壁式鼓室成形术中I期植入钛人工听骨均能有效提高听力。

关键词: 鼓室成形术, 钛人工听骨, 气骨导差

Abstract: Objective

To explore the short-term effects of artificial titanium ossicles in stage I mastoidectomy and tympanoplasty.

Methods

From January 2013 to June 2017, 80 patients (81 ears) who underwent stage I mastoidectomy and tympanoplasty with artificial titanium ossicles were divided in two groups: the canal wall-up tympanoplasty and stage I ossicular implantation group (CWUT; 31 ears) and the canal wall-down tympanoplasty and stage I ossicular implantation group (CWDT; 50 ears). The short-term curative effects of artificial titanium ossicular implantation in these groups were observed and compared.

Results

The average postoperative air-bone gaps (ABG) in CWUT was 18.65±9.46 dB, and the success rate of hearing reconstruction was 83.87%. The average postoperative air-bone gaps (ABG) in CWDT was 19.90±9.42 dB, and the success rate of hearing reconstruction was 62.00%. There were significant differences in the mean values of air and air-bone gaps (ABG) between the groups before and after the operation (P < 0.05). The success rates of postoperative hearing reconstruction between the groups were statistically significant (P < 0.05).

Conclusion

The implantation of artificial titanium auditory ossicles in both CWUT and CWDT improve hearing.

Key words: Tympanoplasty, Artificial titanium ossicle, Air-bone gap

中图分类号: 

  • R764.21

图1

完壁式乳突根治+人工听骨重建,白箭头示外耳道后壁,黄箭头示移植筋膜,蓝箭头示钛听骨"

图2

开放式乳突根治+人工听骨重建。白箭头示鼓室天盖,黄箭头示移植筋膜,蓝箭头示钛听骨"

表1

两组听力情况比较( x ˉ ± s ,dB)"

指标 完壁植入组(n=31) 开放植入组(n=50)
术前 术后6个月 t P 术前 术后6个月 t P
平均气导阈 58.74±10.46 38.68±11.34 11.72 <0.01 57.05±14.84 37.06±12.33 13.03 <0.01
平均骨导阈 19.58±6.44 19.71±6.76 0.33 >0.05 18.25±10.85 17.32±9.68 0.91 >0.05
ABG 39.16±10.28 18.65±9.46 11.98 <0.01 37.94±11.85 19.90±9.42 12.44 <0.01

表2

手术后平均气骨导差改善情况(n)"

术后气骨导差 完壁植入组 开放植入组
合计 31 50
0~10 dB(n=22) 10 12
11~20 dB(n=35) 13 22
>20 dB(n=24) 8 16
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