METHODS: A retrospective review was performed on 86 patients who underwent surgery for the congenital malformation of the ossicular chain. Clinical characteristics and audiometric data were analyzed. Fifty-eight patients had detailed postoperative data, and the preoperative and postoperative audiometric results were compared. The subjects were further divided into endoscopic and microscopic groups, and their surgical effects were examined.
RESULTS: The preoperative audiometry results in the low-frequency group were worse than those in the high-frequency group (P < 0.05). A postoperative air-bone gap closure to 20 dB or less was achieved in 73.33% of the 60 ears of patients postoperatively. The postoperative air conduction and air-bone gap were significantly better than the preoperative ones (P < 0.05), and the improvement effect was the best in class III patients (P < 0.05). Postoperative hearing had no significant differences between the endoscopic and microscopic groups. However, endoscopic surgery also was more advantageous in terms of operating time (P < 0.05).
CONCLUSIONS: Preoperative pure tone audiometric results showed moderate or moderate-severe hearing loss, especially in the low-frequency area. The reconstruction of the auditory ossicle chain can achieve satisfactory results, especially in class III patients. Endoscopic and microscopic surgery in the treatment of simple congenital ossicular chain malformations can effectively improve postoperative hearing.
方法:对86例因先天性听骨链畸形而接受手术的患者进行回顾性分析。分析临床特征和听力数据。58名患者有详细的术后数据,并比较术前和术后的听力测量结果。将受试者进一步分为内镜组和显微镜组,并对其手术效果进行了检查。
结果:低频组术前测听结果较高频组差(P<0.05)。术后60耳的73.33%的患者实现了20dB或更小的术后空气-骨间隙闭合。术后气导及骨间隙明显优于术前(P<0.05),Ⅲ类患者的改善效果最好(P<0.05)。术后听力在内窥镜组和显微镜组之间没有显着差异。然而,内镜手术在手术时间上也更有优势(P<0.05)。
结论:术前纯音听力检测结果显示中度或中重度听力损失,尤其是在低频区。听小骨链的重建能取得满意的效果,尤其是III类患者。内镜及显微手术治疗单纯先天性听骨链畸形可有效改善术后听力。