两种耳内镜下听骨链重建术治疗Ⅲ型先天性听骨链畸形的临床研究OA

Objective To report therapeutic outcomes of endoscopic"Bridging"and"Capping"techniques in the treatment of conductive hearing loss caused by type Ⅲ congenital ossicular chain malformation.Methods Thirty-six cases of type Ⅲ congenital ossicular chain malformation and conductive deafness were retrospectively analyzed.Endoscopic middle ear exploration and ossicular chain reconstruction with partial artificial ossicular prosthesis(PORP)implants were performed under general anesthesia.Pure tone thresholds were compared before and after surgery.Results The mean preoperative air conduction threshold was(53.66±11.36)dB HL with the mean bone conduction threshold at(20.11±12.45)dB HL[mean air-bone gap=(33.62±9.36)dB HL]for patients undergoing the"bridging"procedure,which improved to(34.21±10.62)dB HL with the mean bone conduction threshold at(17.96±10.26)dB HL[mean air-bone gap=(17.56±6.96)dB HL].There were statistically significant differences between preoperative and postoperative conditions(P<0.01).For those receiving the"capping"procedure,the mean preoperative air conduction threshold was(52.71±10.23)dB HL with the mean bone conduction threshold at(19.17±10.12)dB HL[mean air bone gap=(33.36±9.41)dB HL],which improved to(37.62±9.34)dB HL with the mean bone conduction threshold at(18.21±11.22)dB HL[air-bone gap=(19.45±9.33)dB HL].There were statistically significant differences between preoperative and postoperative conditions(P<0.01).Conclusions Both endoscopic ossicular chain reconstruction techniques provide excellent restoration of ossicular chain linkage and good clinical outcomes.