Abstract：
UNASSIGNED: There are no reports about comprehensive comparative analysis of the effects after various hearing surgery solutions for congenital malformation of the middle and outer ear (CMMOE).
UNASSIGNED: To analyze the improvement of Average Air-Conduction Threshold (AACT) of pure tone after various hearing surgery solutions for CMMOE and provide a reference for the selection of accurate hearing solutions.
UNASSIGNED: A retrospective analysis of 159 cases (170 ears) with CMMOE submitted to various ear surgery solutions, including: (1) Three situations of outer ear canal (OEC): ① atresia 85 ears, ② stenosis 28 ears, and ③ normal 57 ears. (2) Three commonly used hearing solutions: eardrum repair 53 ears, Porp 44 ears and Piston 32 ears implantation. (3) Three OEC situations with different hearing solutions: type I. Reconstruction of OEC (r-OEC), type II. r-OEC and/or different tympanoplasty, including ① eardrum repair, ② release of ossicular chain, ③ Porp implantation, and ④ Torp implantation, type III. Piston implantation with fenestration of the inner ear. Compare AACT of postoperative short term (0.5 years) or long term (0.5-10 years) and preoperative in the speech frequency range of 0.5-4 kHz to assess efficacy. If the sample number ≥10, and not subject to normal distribution, the Kruskal-Wallis multi-sample rank sum test is used for the comparison of multiple groups and Wilcoxon\'s rank sum test for two groups, with P < 0.05 being statistically significant. If the sample size <10, the standard of clinical efficacy is one frequency improvement value ≥15 dB HL, or 10 dB HL ≤2 frequency improvements <15 dB HL at 0.125-8 KHz.
UNASSIGNED: Intra-group comparison of AACT: (1) three situations of OEC: atresia, stenosis and normal all had P < 0.05 postoperatively in short term, while in long term only the normal group had P < 0.05. (2) Three commonly used hearing solutions: eardrum repair, Porp and Piston implantation all had P < 0.05 in short and long terms, except for eardrum repair P >0 .05 in long term. (3) Three OEC situations with different hearing solutions: 1) Atresia of OEC: Porp and Piston implantation, r-OEC and release of ossicular chain were effective in short term and were not effective in long term, and the eardrum repair was not effective in both short and long term. 2) Stenosis of OEC: eardrum repair, Porp and Piston implantation were effective in short and long term. r-OEC P >0 .05 for short and long term, Torp implantation was not effective in long term, 3) Normal of OEC: Porp, Torp and Piston implantation were all P < 0.05 in short and long term except for Torp >0.05 in long term, and release of ossicular chain is both short and long term clinically effective. The AACT values of postoperative in long term for three groups of atresia, stenosis, normal of OEC are over 58.7 dB HL (except Porp implantation 52.5 dB HL), 51.3 dB HL (except Porp implantation 42.5 dB HL), and 37.5 dB HL (except Torp implantation are 32.6 dB HL), respectively.
UNASSIGNED: Intra-group comparison of AACT. (1) Three groups of the atresia, stenosis and normal of OEC are all effective in short term, while in long term only the normal group is effective. (2) The three most commonly used surgical solutions of eardrum repair, Porp and Piston implantation are effective in short and long terms, except for long term eardrum repair. (3) Three OEC situations with different hearing solutions: some of surgical solutions were effective in short term or long term for CMMOE, but based on the AACT values of postoperative in long term for three OEC situations, it is better to choose a hearing device for atresia of OEC, comprehensive review of surgical or hearing device for stenosis of OEC. Surgery can be considered for normal OEC.
UNASSIGNED: To analyze the improvement of Average Air-Conduction Threshold (AACT) of pure tone after various hearing surgery solutions for CMMOE and provide a reference for the selection of accurate hearing solutions.
UNASSIGNED: A retrospective analysis of 159 cases (170 ears) with CMMOE submitted to various ear surgery solutions, including: (1) Three situations of outer ear canal (OEC): ① atresia 85 ears, ② stenosis 28 ears, and ③ normal 57 ears. (2) Three commonly used hearing solutions: eardrum repair 53 ears, Porp 44 ears and Piston 32 ears implantation. (3) Three OEC situations with different hearing solutions: type I. Reconstruction of OEC (r-OEC), type II. r-OEC and/or different tympanoplasty, including ① eardrum repair, ② release of ossicular chain, ③ Porp implantation, and ④ Torp implantation, type III. Piston implantation with fenestration of the inner ear. Compare AACT of postoperative short term (0.5 years) or long term (0.5-10 years) and preoperative in the speech frequency range of 0.5-4 kHz to assess efficacy. If the sample number ≥10, and not subject to normal distribution, the Kruskal-Wallis multi-sample rank sum test is used for the comparison of multiple groups and Wilcoxon\'s rank sum test for two groups, with P < 0.05 being statistically significant. If the sample size <10, the standard of clinical efficacy is one frequency improvement value ≥15 dB HL, or 10 dB HL ≤2 frequency improvements <15 dB HL at 0.125-8 KHz.
UNASSIGNED: Intra-group comparison of AACT: (1) three situations of OEC: atresia, stenosis and normal all had P < 0.05 postoperatively in short term, while in long term only the normal group had P < 0.05. (2) Three commonly used hearing solutions: eardrum repair, Porp and Piston implantation all had P < 0.05 in short and long terms, except for eardrum repair P >0 .05 in long term. (3) Three OEC situations with different hearing solutions: 1) Atresia of OEC: Porp and Piston implantation, r-OEC and release of ossicular chain were effective in short term and were not effective in long term, and the eardrum repair was not effective in both short and long term. 2) Stenosis of OEC: eardrum repair, Porp and Piston implantation were effective in short and long term. r-OEC P >0 .05 for short and long term, Torp implantation was not effective in long term, 3) Normal of OEC: Porp, Torp and Piston implantation were all P < 0.05 in short and long term except for Torp >0.05 in long term, and release of ossicular chain is both short and long term clinically effective. The AACT values of postoperative in long term for three groups of atresia, stenosis, normal of OEC are over 58.7 dB HL (except Porp implantation 52.5 dB HL), 51.3 dB HL (except Porp implantation 42.5 dB HL), and 37.5 dB HL (except Torp implantation are 32.6 dB HL), respectively.
UNASSIGNED: Intra-group comparison of AACT. (1) Three groups of the atresia, stenosis and normal of OEC are all effective in short term, while in long term only the normal group is effective. (2) The three most commonly used surgical solutions of eardrum repair, Porp and Piston implantation are effective in short and long terms, except for long term eardrum repair. (3) Three OEC situations with different hearing solutions: some of surgical solutions were effective in short term or long term for CMMOE, but based on the AACT values of postoperative in long term for three OEC situations, it is better to choose a hearing device for atresia of OEC, comprehensive review of surgical or hearing device for stenosis of OEC. Surgery can be considered for normal OEC.
摘要：
■没有关于中耳和外耳先天性畸形（CMMOE）的各种听力手术解决方案后效果的综合比较分析的报道。
■分析CMMOE各种听力手术解决方案后纯音平均空气传导阈值（AACT）的改善情况，为选择准确的听力解决方案提供参考。
■对接受各种耳部手术方案的159例（170耳）CMMOE患者进行回顾性分析，包括：（1）外耳道（OEC）的三种情况：①闭锁85耳，②狭窄28耳，③正常57耳。（2）三种常用的听力解决方案：耳膜修复53耳，门44耳和活塞32耳植入。（3）具有不同听力解决方案的三种OEC情况：类型I.OEC的重建（r-OEC），II型。r-OEC和/或不同的鼓室成形术，包括①耳膜修复,②听骨链释放，③口交植入，和④Torp植入，III型。内耳开窗的活塞植入。比较术后短期（0.5年）或长期（0.5-10年）和术前在0.5-4kHz语音频率范围内的AACT以评估疗效。如果样本数≥10，并且不服从正态分布，Kruskal-Wallis多样本秩和检验用于多组的比较，Wilcoxon秩和检验用于两组，P<0.05有统计学意义。如果样本量<10，临床疗效的标准是一个频率改善值≥15dBHL，或10dBHL≤2频率改善<15dBHL在0.125-8KHz。
■AACT的组内比较：（1）OEC的三种情况：闭锁，术后短期内狭窄和正常均P<0.05,而长期仅正常组P<0.05。（2）三种常用的听力解决方案：耳膜修复，Porp和Piston植入在短期和长期均P<0.05，除了耳膜修复P>0.05长期。（3）三种具有不同听力解决方案的OEC情况：1）OEC的闭锁：Porp和活塞植入，r-OEC和听骨链释放短期有效，长期无效，耳膜修复在短期和长期都无效。2）OEC狭窄：耳膜修复，Porp和Piston植入在短期和长期均有效。短期和长期R-OECP>0.05，Torp植入长期无效，3）OEC的正常：Porp，Torp和活塞植入在短期和长期均P<0.05，除了长期Torp>0.05。听骨链的释放是短期和长期临床有效。三组闭锁术后长期AACT值,狭窄,OEC的正常值超过58.7dBHL（除了Porp植入52.5dBHL），51.3dBHL（Porp植入42.5dBHL除外），和37.5dBHL（除了Torp植入是32.6dBHL），分别。
■AACT的组内比较。(1)三组闭锁,OEC的狭窄和正常都是短期有效的，而从长远来看，只有正常组是有效的。(2)三种最常用的耳膜修复手术方案,波特和活塞植入在短期和长期都是有效的，除了长期的耳膜修复。（3）三种不同听力解决方案的OEC情况：某些手术解决方案对CMMOE短期或长期有效，但是根据三种OEC情况的术后长期AACT值，最好选择用于OEC闭锁的听力设备，OEC狭窄的手术或听力设备的综合审查。对于正常的OEC可以考虑手术。
■分析CMMOE各种听力手术解决方案后纯音平均空气传导阈值（AACT）的改善情况，为选择准确的听力解决方案提供参考。
■对接受各种耳部手术方案的159例（170耳）CMMOE患者进行回顾性分析，包括：（1）外耳道（OEC）的三种情况：①闭锁85耳，②狭窄28耳，③正常57耳。（2）三种常用的听力解决方案：耳膜修复53耳，门44耳和活塞32耳植入。（3）具有不同听力解决方案的三种OEC情况：类型I.OEC的重建（r-OEC），II型。r-OEC和/或不同的鼓室成形术，包括①耳膜修复,②听骨链释放，③口交植入，和④Torp植入，III型。内耳开窗的活塞植入。比较术后短期（0.5年）或长期（0.5-10年）和术前在0.5-4kHz语音频率范围内的AACT以评估疗效。如果样本数≥10，并且不服从正态分布，Kruskal-Wallis多样本秩和检验用于多组的比较，Wilcoxon秩和检验用于两组，P<0.05有统计学意义。如果样本量<10，临床疗效的标准是一个频率改善值≥15dBHL，或10dBHL≤2频率改善<15dBHL在0.125-8KHz。
■AACT的组内比较：（1）OEC的三种情况：闭锁，术后短期内狭窄和正常均P<0.05,而长期仅正常组P<0.05。（2）三种常用的听力解决方案：耳膜修复，Porp和Piston植入在短期和长期均P<0.05，除了耳膜修复P>0.05长期。（3）三种具有不同听力解决方案的OEC情况：1）OEC的闭锁：Porp和活塞植入，r-OEC和听骨链释放短期有效，长期无效，耳膜修复在短期和长期都无效。2）OEC狭窄：耳膜修复，Porp和Piston植入在短期和长期均有效。短期和长期R-OECP>0.05，Torp植入长期无效，3）OEC的正常：Porp，Torp和活塞植入在短期和长期均P<0.05，除了长期Torp>0.05。听骨链的释放是短期和长期临床有效。三组闭锁术后长期AACT值,狭窄,OEC的正常值超过58.7dBHL（除了Porp植入52.5dBHL），51.3dBHL（Porp植入42.5dBHL除外），和37.5dBHL（除了Torp植入是32.6dBHL），分别。
■AACT的组内比较。(1)三组闭锁,OEC的狭窄和正常都是短期有效的，而从长远来看，只有正常组是有效的。(2)三种最常用的耳膜修复手术方案,波特和活塞植入在短期和长期都是有效的，除了长期的耳膜修复。（3）三种不同听力解决方案的OEC情况：某些手术解决方案对CMMOE短期或长期有效，但是根据三种OEC情况的术后长期AACT值，最好选择用于OEC闭锁的听力设备，OEC狭窄的手术或听力设备的综合审查。对于正常的OEC可以考虑手术。
