目的:本研究比较了两种假体材料的听力结果,骨和钛,用于骨成形术。
方法:这项基于全国注册的回顾性研究使用了由瑞典耳手术质量注册中心(SwedEar)收集的系统数据。
方法:数据来自瑞典进行骨成形术的诊所。
方法:在2013年至2019年期间,在SwedEar注册了使用骨或钛假体进行骨成形术的患者。
方法:听力结果表示为空气-骨间隙(ABG)增益。
结果:研究发现,对于部分听骨置换假体(PORP)或全听骨置换假体(TORP),ABG或空气传导(AC)的骨和钛之间没有差异。在ABG和AC结果的PORP和TORP之间的比较中,无论使用何种材料,PORP显示了一个小优势,额外提高了3.3dB(95%CI[置信区间],在ABG中为0.1-4.4),在AC中为2.2dB(95%CI,1.7-4.8)。在使用TORP的二次手术中,钛产生的高频纯音平均略好的结果。成功率,a术后ABG≤20dB,在整个集团62%的运营中实现了目标。
结论:用于重建听骨链的骨和钛对于PORP和TORP手术均产生相似的听力结果。然而,钛可能是涉及TORP的二次手术的首选。成功率,a术后ABG≤20dB,与其他研究一致,但患者选择标准和手术技术仍有改进的空间。
OBJECTIVE: This study compares hearing outcomes of two prosthesis materials, bone and titanium, used in ossiculoplasty.
METHODS: This retrospective nationwide registry-based study uses data systematically collected by the Swedish Quality Registry for Ear Surgery (SwedEar).
METHODS: The data were obtained from clinics in Sweden that perform ossiculoplasty.
METHODS: Patients who underwent ossiculoplasty using either bone or titanium prostheses were registered in SwedEar between 2013 and 2019.
METHODS: Hearing outcome expressed as air-bone gap (ABG) gain.
RESULTS: The study found no differences between bone and titanium for ABG or air conduction (AC) for either partial ossicular replacement prostheses (PORP) or total ossicular replacement prostheses (TORP). In a comparison between PORP and TORP for ABG and AC outcomes, regardless of the material used, PORP showed a small advantage, with an additional improvement of 3.3 dB (95% CI [confidence interval], 0.1-4.4) in ABG and 2.2 dB (95% CI, 1.7-4.8) in AC. In secondary surgery using TORP, titanium produced slightly better results for high-frequency pure tone average. The success rate, a postoperative ABG ≤20 dB, was achieved in 62% of the operations for the whole group.
CONCLUSIONS: Both bone and titanium used to reconstruct the ossicular chain produce similar hearing outcomes for both PORP and TORP procedures. However, titanium may be a preferable option for secondary surgeries involving TORP. The success rate, a postoperative ABG ≤20 dB, is consistent with other studies, but there is room for improvement in patient selection criteria and surgical techniques.