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目的:探讨先天性听骨链畸形的诊断及手术疗效。方法:14例(15耳)先天性听骨链畸形患者,其中10例为单侧传导性聋,1例为双侧传导性聋,3例混合性聋且以传导性为主。15耳均行鼓室探查,并行14耳听骨链重建术(3耳行全听骨重建术,10耳行部分听骨重建术,1耳行人工镫骨手术),1例松解听骨链与鼓室壁的软骨固定。通过术前术后气骨导差比较疗效。结果:术前听力检查示平均气骨导差为39.9dB,术后3周平均气骨导差为22.3dB,较术前缩小17.6dB(t=22.10,P<0.01),术后6~8个月平均气骨导差为19.6dB,较术前缩小20.3dB(t=12.813,P<0.01)。结论:先天性听骨链畸形引起的传导性听力下降,根据术中情况采用不同听骨链重建术可以明显提高听力,以手术治疗为首选。
Objective: To investigate the diagnosis and surgical treatment of congenital ossicular chain deformity. Methods: Fourteen patients (15 ears) with congenital ossicular deformity were involved in this study. Ten of them were unilateral conduction deafness, one was bilateral conduction deafness and three were mixed hearing loss. 15 ears were performed tympanic exploration, 14 cases of ossicular chain reconstruction (3 ears total ossification reconstruction, 10 ears partial ossification reconstruction, 1 ear artificial stapes operation), 1 case of loosen ossicular chain Cartilage with tympanic wall fixed. Through the preoperative and postoperative difference in the efficacy of air-conduction. Results: The preoperative hearing tests showed that the mean airway densities were 39.9dB and the mean airway densities at 3 weeks after operation were 22.3dB, which were 17.6dB less than those before operation (t = 22.10, P <0.01) The average monthly mean air-hole difference was 19.6dB, which was 20.3dB lower than that before operation (t = 12.813, P <0.01). CONCLUSION: Conductivity hearing loss caused by congenital ossicular chain deformity can be significantly improved by using different ossicular chain reconstruction according to the intraoperative situation. Surgical treatment is the first choice.