METHODS: TEES was performed on 11 ears (10 with congenital ossicular chain discontinuity and 1 with traumatic ossicular chain dislocation), and MES was performed with a retroauricular incision on 18 ears (6 with congenital ossicular chain discontinuity and 12 with traumatic ossicular chain dislocation) in a tertiary referral center. Postoperative hearing results, operative times, and postoperative hospital length of stay were retrospectively reviewed. The Mann-Whitney U test and Fisher\'s exact test was performed to compare variables between the TEES and MES groups. Pre- and postoperative air- and bone-conduction thresholds and the air-bone gap of each group were compared using the Wilcoxon signed-rank test. The Mann-Whitney U test and Wilcoxon signed-rank was performed to compare the pre- and postoperative air-bone gaps between the diagnoses.
RESULTS: No significant differences in the postoperative air-conduction thresholds, bone-conduction thresholds, air-bone gaps, or incidence of air-bone gap ≤ 20 dB were observed between the TEES and MES groups. The air-conduction thresholds and air-bone gaps of the TEES group significantly improved postoperatively. The air-conduction thresholds and air-bone gaps of the MES group also significantly improved postoperatively. No significant difference was observed in the operative times between the groups (TEES group: median, 80 min; MES group: median, 85.5 min). The TEES group had a significantly shorter postoperative hospital stay (median, 2 days) than the MES group (median, 7.5 days).
CONCLUSIONS: TEES was considered appropriate for the treatment of ossicular chain disruption, even immediately after its introduction at our institution. For expert microscopic ear surgeons, ossicular chain disruption may be considered a suitable indication for the introduction of TEES.
方法:对11只耳进行TEES(10只为先天性听骨链不连续,1只为外伤性听骨链脱位),在三级转诊中心,对18耳(6耳先天性听骨链不连续,12耳外伤性听骨链脱位)进行了耳后切口MES。术后听力结果,手术时间,并对术后住院时间进行回顾性分析.进行Mann-WhitneyU检验和Fisher精确检验以比较TEES和MES组之间的变量。使用Wilcoxon符号秩检验比较各组的术前和术后空气和骨传导阈值以及空气-骨间隙。进行了Mann-WhitneyU检验和Wilcoxonsigned-rank,以比较诊断前后的气骨间隙。
结果:术后空气传导阈值无显著差异,骨传导阈值,空气-骨骼间隙,在TEES组和MES组之间观察到气-骨间隙≤20dB的发生率。TEES组的空气传导阈值和空气骨间隙在术后显着改善。MES组的空气传导阈值和空气-骨间隙也在术后显着改善。两组之间的手术时间没有显着差异(TEES组:中位数,80分钟;MES组:中位数,85.5分钟)。TEES组术后住院时间明显缩短(中位数,2天)比MES组(中位数,7.5天)。
结论:TEES被认为适合治疗听骨链断裂,甚至在我们机构推出后立即推出。对于专业的显微耳外科医生来说,听骨链破坏可被认为是引入TEES的合适指征。