先天性聽小骨異常的手術治療

Surgical Treatment of Congenital Ossicular Anomalies

黃鈞儒(Chun-Ju Huang) ； 賴仁淙(Jen-Tsung Lai)

《中華民國耳鼻喉科醫學雜誌》 36卷3期 (2001/03) Pp. 155-159

https://doi.org/10.6286/2001.36.3.155

摘要

BACKGROUND: Congenital ossicular anomalies are rarely unaccompanied by abnormalities of the external ear. We review our surgical experience with such patients and the hearing outcomes described in the literature.
METHODS: Between January 1995 and December 1999, exploratory tympanotomy was performed on 22 ears in 21 patients with conductive hearing loss but without external ear malformations. The following data were collected and analyzed: otological history, intra-operative findings, types of ossicular chain reconstruction and hearing results.
RESULTS: Twelve men and nine women were recruited, with an average age of 19 years. Sixteen patients had (＞10dB) improvements in hearing postoperatively. The average air-bone gap improved from 39 dB preoperatively to 21 dB postoperatively. Congenital stapes footplate fixation was the most common abnormality (14 ears). With the exception of two ears where staged operations were arranged to treat coexisting congenital cholesteatomas, ossicular chain reconstruction was performed with myringoplatinopexy in two ears, myringovestibulopexy in six ears and stapedotomy with a piston-wire prosthesis in 12 ear.
CONCLUSIONS: preoperative preparation is important due to the likelihood of stapes footplate surgery being required when repairing congenital ossicular anomalies. For treatment of congenital stapes footplate fixation, the effects of myringovestibulopexy with TORP and stapedotomy with a piston-wire prosthesis should be equivalent. The method used should be based on the pattern of ossicular anomalies encountered during surgery.

關鍵字

先天性聽小骨異常 ； 先天性鐙骨足板固定

並列摘要

BACKGROUND: Congenital ossicular anomalies are rarely unaccompanied by abnormalities of the external ear. We review our surgical experience with such patients and the hearing outcomes described in the literature.
METHODS: Between January 1995 and December 1999, exploratory tympanotomy was performed on 22 ears in 21 patients with conductive hearing loss but without external ear malformations. The following data were collected and analyzed: otological history, intra-operative findings, types of ossicular chain reconstruction and hearing results.
RESULTS: Twelve men and nine women were recruited, with an average age of 19 years. Sixteen patients had (＞10dB) improvements in hearing postoperatively. The average air-bone gap improved from 39 dB preoperatively to 21 dB postoperatively. Congenital stapes footplate fixation was the most common abnormality (14 ears). With the exception of two ears where staged operations were arranged to treat coexisting congenital cholesteatomas, ossicular chain reconstruction was performed with myringoplatinopexy in two ears, myringovestibulopexy in six ears and stapedotomy with a piston-wire prosthesis in 12 ear.
CONCLUSIONS: preoperative preparation is important due to the likelihood of stapes footplate surgery being required when repairing congenital ossicular anomalies. For treatment of congenital stapes footplate fixation, the effects of myringovestibulopexy with TORP and stapedotomy with a piston-wire prosthesis should be equivalent. The method used should be based on the pattern of ossicular anomalies encountered during surgery.

並列關鍵字

congenital ossicular anomaly ； congenital stapes footplate fixation