目的:与其他中耳手术相比,revision骨手术是一项具有挑战性的手术,数量相对较少。尽管有关不同中耳手术的听力结果的数据众多,该程序成功结果的听力学标准仍未明确。根据有据可查的数据,我们希望确定骨修复手术后预期的听力学结果和并发症,以便为手术成功设定一个现实的阈值.
方法:在PROSPERO数据库中注册协议后,在多个数据库(PubMed,科克伦,WebofScience,Scopus,科学开放,ClinicalTrials.gov,谷歌学者)根据PRISMA准则。根据纳入标准对12篇文章进行综述。共获得1032例用于评估。使用改良版本的纽卡斯尔-渥太华量表(NOS)来评估出版质量。
结果:平均空骨间隙(ABG)增益为17.3dB,平均空气传导(AC)增益为17.5dB。术后气-骨间隙平均为11.1dB。术后ABG分布为0-10dB:53.3%,>10-20dB:28.2%,>20dB:18.5%。SNHL作为手术并发症被描述为总共17例(1.6%),没有平衡紊乱的报告。
结论:汇总的数据表明,在先前的stapes骨手术失败后,翻修stapes骨手术是一种有效的解决方案。然而,结果明显不如原发性stapedotomes。因此,在这种手术的适应证和评估中,我们需要应用不同的期望和使用不同的标准。
OBJECTIVE: Revision
stapes surgery is a challenging procedure performed in relatively small numbers compared to other middle ear procedures. Despite numerous data on hearing results of different middle ear surgeries, the audiological standards for successful outcome of this procedure are still not clarified. On the basis of well-documented data, we wanted to determine what the expected audiological results and complications are after revision
stapes surgery in order to set a realistic threshold for surgical success.
METHODS: After the protocol registration in the PROSPERO database, a systematic review was performed in multiple databases (PubMed, Cochrane, Web of Science, Scopus, ScienceOpen, ClinicalTrials.gov, Google Scholar) according to PRISMA guidelines. Twelve articles were reviewed according to the inclusion criteria. A total of 1032 cases were obtained for evaluation. A modified version of Newcastle-Ottawa Scale (NOS) was used to assess publication quality.
RESULTS: Average air-bone gap (ABG) gain was 17.3 dB, average air conduction (AC) gain was 17.5 dB. The average postoperative air-bone gap was 11.1 dB. The postoperative ABG distribution was the following 0-10 dB: 53.3%, > 10-20 dB: 28.2%, > 20 dB: 18.5%. SNHL as a surgical complication was described in a total of 17 cases (1.6%), no equilibrium disorder was reported.
CONCLUSIONS: The pooled data suggest that revision
stapes surgery is an effective solution after failure of previous
stapes surgery. However, the results are clearly inferior to those of primary stapedotomies. Hence, we need to apply different expectations and use different standards in the indication and evaluation of this type of surgery.