Abstract：
OBJECTIVE: The aim of the current study is to compare the surgical and audiometric results of conventional incus interposition (IP) versus malleostapediopexy (MS) in incus long process large defects.
METHODS: A total of 71 patients (incus IP group n = 37, MS group n = 34) were enrolled in this study. All patients enrolled in the current study underwent ossiculoplasty via an exclusive endoscopic transcanal approach. Pre- and postoperative audiometric measurements and air-bone gap (ABG) values were compared, and if the postoperative ABG value was less than 20 dB, ossiculoplasty was considered successful. Graft success rates and complications were also compared.
RESULTS: The average auditory gain was 14.7 ± 4.2 dB in the incus IP group and 18.3 ± 5.1 dB in the MS group. The auditory gain was significantly greater in the MS group relative to the incus IP group (p = 0.012). Ossiculoplasty success (postoperative ABG value < 20 dB) rate was 70.3% in the incus IP group patients and 88.2% in the MS group patients (p < 0.001). There was no significant difference in terms of graft success rate between groups (p > 0.05) and the overall graft uptake rate was 91.5% (65/71).
CONCLUSIONS: Malleostapediopexy-bridging of malleus and stapes using bone cement-is an effective, reasonable, and more efficient technique in terms of auditory outcomes relative to the conventional incus interposition in endoscopic transcanal management of incus long process major defects.
METHODS: A total of 71 patients (incus IP group n = 37, MS group n = 34) were enrolled in this study. All patients enrolled in the current study underwent ossiculoplasty via an exclusive endoscopic transcanal approach. Pre- and postoperative audiometric measurements and air-bone gap (ABG) values were compared, and if the postoperative ABG value was less than 20 dB, ossiculoplasty was considered successful. Graft success rates and complications were also compared.
RESULTS: The average auditory gain was 14.7 ± 4.2 dB in the incus IP group and 18.3 ± 5.1 dB in the MS group. The auditory gain was significantly greater in the MS group relative to the incus IP group (p = 0.012). Ossiculoplasty success (postoperative ABG value < 20 dB) rate was 70.3% in the incus IP group patients and 88.2% in the MS group patients (p < 0.001). There was no significant difference in terms of graft success rate between groups (p > 0.05) and the overall graft uptake rate was 91.5% (65/71).
CONCLUSIONS: Malleostapediopexy-bridging of malleus and stapes using bone cement-is an effective, reasonable, and more efficient technique in terms of auditory outcomes relative to the conventional incus interposition in endoscopic transcanal management of incus long process major defects.
摘要：
目的：本研究的目的是比较常规砧骨间置术（IP）和踝骨固定术（MS）在砧骨长过程大缺陷中的手术和听力测量结果。
方法：本研究共纳入71例患者（Ip组37例，MS组34例）。本研究中的所有患者均通过独家内窥镜经管入路进行了骨成形术。比较术前和术后听力测量和气-骨间隙（ABG）值，如果术后ABG值小于20dB,骨成形术被认为是成功的。还比较了移植成功率和并发症。
结果：砧骨IP组的平均听觉增益为14.7±4.2dB，MS组为18.3±5.1dB。MS组的听觉增益明显高于Ip组（p=0.012）。肩关节成形术成功率(术后ABG值<20dB)在砧骨IP组患者中为70.3%,在MS组患者中为88.2%(p<0.001)。各组间移植成功率无显著差异(p>0.05),总体移植物摄取率为91.5%(65/71)。
结论：使用骨水泥桥接锤骨和骨是一种有效的，合理,相对于传统的插入插入技术，在内窥镜下经运河处理的砧骨长过程主要缺陷的听觉结果方面更有效。
方法：本研究共纳入71例患者（Ip组37例，MS组34例）。本研究中的所有患者均通过独家内窥镜经管入路进行了骨成形术。比较术前和术后听力测量和气-骨间隙（ABG）值，如果术后ABG值小于20dB,骨成形术被认为是成功的。还比较了移植成功率和并发症。
结果：砧骨IP组的平均听觉增益为14.7±4.2dB，MS组为18.3±5.1dB。MS组的听觉增益明显高于Ip组（p=0.012）。肩关节成形术成功率(术后ABG值<20dB)在砧骨IP组患者中为70.3%,在MS组患者中为88.2%(p<0.001)。各组间移植成功率无显著差异(p>0.05),总体移植物摄取率为91.5%(65/71)。
结论：使用骨水泥桥接锤骨和骨是一种有效的，合理,相对于传统的插入插入技术，在内窥镜下经运河处理的砧骨长过程主要缺陷的听觉结果方面更有效。
