Endoscopic Laser Stapedotomy for the Treatment of Otosclerosis

以內視鏡進行雷射鐙骨造口術治療耳硬化症病患之探討

郭家瑋(Chia-Wei Kuo) ； 吳幸美(Hsing-Mei Wu)

《台灣耳鼻喉頭頸外科雜誌》 50卷2期 (2015/06) Pp. 124-131

https://doi.org/10.6286/2015.50.2.124

摘要

背景：本篇研究目的在於探討以內視鏡進行雷射鐙骨造口術治療耳硬化症病患之可行性，同時分析其優點、缺點及聽力改善情況。方法：從2014年4月至2014年9月共有4名病患接受內視鏡雷射鐙骨造口術，2011年1月至2012年3月共8名病患接受傳統顯微鏡鐙骨切除術。針對病患資料及手術錄影進行回溯性研究，評估術中解剖結構、手術時間，並在術後3個月進行純音聽力檢查以評估術後聽力。結果：以內視鏡進行手術其手術視野清晰，解剖結構易於辨認，且不需要犧牲非病灶之骨頭結構。以內視鏡進行手術之手術時間明顯比顯微鏡組來得長。聽力改善狀況兩組都有顯著改善，但兩組間無顯著差異。結論：全內視鏡鐙骨手術為可行且安全之手術方式，且聽力結果佳，但內視鏡手術可能需比較長的學習過程，才能達到和顯微鏡手術有相同的手術時間和聽力效果。

關鍵字

內視鏡 ； 鐙骨造口術 ； 耳硬化症

並列摘要

BACKGROUND: The aim of this study was to investigate endoscopic laser stapedotomy in treating patients with otosclerosis, and to analyze the potential advantages, disadvantages, and hearing outcomes. METHODS: Four patients from April 2014 to September 2014 who underwent endoscopic laser stapedotomy were enrolled and, compared to eight patients who underwent conventional microscopic stapedotomy from January 2011 to March 2012. Data and video of the surgeries were analyzed retrospectively. The anatomical structures were identified and the operative time determined, and hearing outcomes were assessed by pure tone audiograms three months after surgery. RESULTS: Using an endoscope, the operative field was clear with easily identified anatomy without needing to sacrifice bony structures. The operative time was significantly longer in the endoscopic group. Hearing improvements were significant in both the endoscopic and microscopic groups, however there was no significant difference between the two groups. CONCLUSIONS: Fully endoscopic stapes surgery is a feasible and safe surgical technique with satisfactory hearing outcomes, but it may take longer learning curve to achieve shorter endoscopic operation time.

並列關鍵字

endoscope ； stapedotomy ； otosclerosis