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Abstract：
OBJECTIVE: To delineate the advantages and steps of stapedotomy with incus vibroplasty, to assess the safety and efficacy of this method via the authors\' experiences, and to overview the literature regarding other surgical options in advanced otosclerosis determining the place of stapedotomy with incus vibroplasty in the therapeutic range.
METHODS: Four patients were enrolled in the study presenting severe mixed hearing loss of at least one side on pure tone audiometry. Based on complementary audiological examinations including stapedial reflex test and multifrequency tympanometry, all cases were suspected as advanced otosclerosis. Stapedotomy with incus vibroplasty - the combination of laser stapedotomy and simultaneous Vibrant Soundbridge implantation - was performed in each patient. Preoperative pure tone average, speech recognition thresholds and word recognition scores were compared to one-year postoperative free-field values with the implant switched on focusing on functional gain.
RESULTS: Among 4 participants (3 females, 1 male) the mean age (SD) was 66 years (35). In three cases Nitinol, in one case NitiBond piston was inserted. One-year postoperative free-field functional gains were 30 dB, 34 dB, 42 dB and 51 dB, respectively. One-year postoperative free-field speech recognition thresholds were 45 dB, 45 dB, 49 dB and 50 dB, respectively, while word recognition scores were 70%, 70%, 70% and 75%, respectively.
CONCLUSIONS: Postoperative results in our serie regarding pure tone average and word recognition score proved to be better than those found in the literature. Stapedotomy with incus vibroplasty - through sufficient air-bone gap closure and simultaneous sensorineural component management - seems to be a promising surgical solution in advanced otosclerosis, requiring further investigation.
METHODS: Four patients were enrolled in the study presenting severe mixed hearing loss of at least one side on pure tone audiometry. Based on complementary audiological examinations including stapedial reflex test and multifrequency tympanometry, all cases were suspected as advanced otosclerosis. Stapedotomy with incus vibroplasty - the combination of laser stapedotomy and simultaneous Vibrant Soundbridge implantation - was performed in each patient. Preoperative pure tone average, speech recognition thresholds and word recognition scores were compared to one-year postoperative free-field values with the implant switched on focusing on functional gain.
RESULTS: Among 4 participants (3 females, 1 male) the mean age (SD) was 66 years (35). In three cases Nitinol, in one case NitiBond piston was inserted. One-year postoperative free-field functional gains were 30 dB, 34 dB, 42 dB and 51 dB, respectively. One-year postoperative free-field speech recognition thresholds were 45 dB, 45 dB, 49 dB and 50 dB, respectively, while word recognition scores were 70%, 70%, 70% and 75%, respectively.
CONCLUSIONS: Postoperative results in our serie regarding pure tone average and word recognition score proved to be better than those found in the literature. Stapedotomy with incus vibroplasty - through sufficient air-bone gap closure and simultaneous sensorineural component management - seems to be a promising surgical solution in advanced otosclerosis, requiring further investigation.
摘要：
目的：为了描述截骨切开术加倒刺成形术的优点和步骤，通过作者的经验评估这种方法的安全性和有效性，并概述有关晚期耳硬化症的其他手术选择的文献，以确定在治疗范围内进行截骨切开术的位置。
方法：4例患者在纯音测听术中表现为至少一侧的严重混合性听力损失。基于补充的听力学检查，包括骨反射测试和多频鼓室测压，所有病例均怀疑为晚期耳硬化症.每位患者都进行了Staped切开术和砧骨振动成形术-激光staped切开术和同时的VibrantSoundbridge植入的组合。术前纯音平均,我们将语音识别阈值和单词识别评分与术后1年自由场值进行了比较,同时将植入物置于功能增益上.
结果：在4名参与者中（3名女性，1）男性，平均年龄（SD）为66岁（35岁）。在三种情况下，镍钛诺，在一种情况下，插入了NitiBond活塞。术后1年自由场功能增益为30dB,34dB,42dB和51dB，分别。术后1年自由场语音识别阈值为45dB,45dB,49dB和50dB,分别,单词识别分数为70%，70%,70%和75%，分别。
结论：我们系列的术后结果在纯音平均和单词识别得分方面被证明优于文献中的结果。结扎切开术与砧骨振动成形术-通过足够的空气-骨间隙闭合和同时的感觉神经质成分管理-似乎是晚期耳硬化症的有前途的手术解决方案，需要进一步调查。
方法：4例患者在纯音测听术中表现为至少一侧的严重混合性听力损失。基于补充的听力学检查，包括骨反射测试和多频鼓室测压，所有病例均怀疑为晚期耳硬化症.每位患者都进行了Staped切开术和砧骨振动成形术-激光staped切开术和同时的VibrantSoundbridge植入的组合。术前纯音平均,我们将语音识别阈值和单词识别评分与术后1年自由场值进行了比较,同时将植入物置于功能增益上.
结果：在4名参与者中（3名女性，1）男性，平均年龄（SD）为66岁（35岁）。在三种情况下，镍钛诺，在一种情况下，插入了NitiBond活塞。术后1年自由场功能增益为30dB,34dB,42dB和51dB，分别。术后1年自由场语音识别阈值为45dB,45dB,49dB和50dB,分别,单词识别分数为70%，70%,70%和75%，分别。
结论：我们系列的术后结果在纯音平均和单词识别得分方面被证明优于文献中的结果。结扎切开术与砧骨振动成形术-通过足够的空气-骨间隙闭合和同时的感觉神经质成分管理-似乎是晚期耳硬化症的有前途的手术解决方案，需要进一步调查。
