耳内镜下自体听骨链重建术的应用.PDF

·181 · Chinese Journal of Otology Vo1.16,No.2 , 2018 ·临床研究 · 耳内镜下自体听骨链重建术的应用 梁伟英 关亚峰 陆钊群 杨美华 李金贵 曾敬贤 香港大学深圳医院耳鼻咽喉头颈外科（深圳 518053 ） 【摘要】目的 探讨耳内镜下行自体听骨链重建术的经验和优势。方法 回顾性分析耳内镜下行自体听骨链重 建加鼓室成形术32 例，随访6 个月～3 年,平均18个月，观察术后鼓膜愈合情况及术后并发症，比较手术前后的平 均气导听阈（AC ）及气骨导差（ABGap ）。结果32 例患者中31 例术后鼓膜修复完整（占96.9%）。术前患者平均气导 听阈48.0 ± 18.3dB ，提高到术后30.6± 12.1dB （t=2.453 ，P0.05 ），ABGap 由术前36.6± 16.8dB 缩小到16.0 ±8.5dB （t= 2.744 ，P0.05 ）。无1例患者术后面神经瘫痪，味觉改变，眩晕，自体听骨脱出，中耳疾病复发。有1例患者术后高 频轻度感音神经性听力下降，伴术后耳鸣，其余31 例患者术后无感音神经性听力下降。结论耳内镜下行自体听骨 链重建术，优点是取材方便，术野清楚，创伤少，术后听力效果好，术后恢复时间快，缺点是单手操作，尤其在中耳渗 血情况下不利于精细操作。 【关键词】鼓室成形术；耳内镜手术；自体听骨；听骨链重建术 【中图分类号】R764 【文献标识码】A 【文章编号】1672-2922 （2018 ）02-181-5 Endoscopic Ossiculoplasty with Autogenous Ossicles LIANG Weiying , GUAN Yafeng , LU Zhaoqun , YANG Meihua , LI Jingui , Raymond K. Tsang Department of Otorhinolaryngology Head and Neck Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China Corresponding author: Raymond K. Tsang Email: rkytsang@hku.hk 【Abstract 】Objective To report the experience and advantagesof endoscopic ossiculoplasty with autogenous ossi- cles. Methods The study was a retrospective analysis of 32 patients who received endoscopic tympanoplasty and ossicu- loplasty with autogenous ossicles. Tympanic membrane healing results and postoperative complications were assessed. The average pre- and postoperative pure tune audiometry air conduction thresholds (AC), as well as changes in air-bone gap (ABGap), were compared to determine degree of improvement. Results Tympanic membranes were successfully re- paired in 31 patients (96.9%). The avera