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目的探讨镫骨手术对晚期耳硬化症的治疗效果。方法随机抽取300例1970年至1999年间的耳硬化症手术病例,对符合晚期耳硬化症标准[500～2000Hz骨导听阈(听力级,下同)均值≥40dB,气导听阈均值≥70dB的混合性聋]的68例(77耳)进行回顾性分析。结果68例(77耳)术后,500～2000Hz纯音平均听阈:气导(听力级,下同)由术前的77.32dB减至53.70dB,提高23.62dB;71耳(92.21%)气导提高≥10dB,其中46耳(59.74%)气骨导差闭合。500～4000Hz纯音平均听阈:气导由79.01dB减至58.23dB,提高20.78dB;68耳(88.31%)气导提高≥10dB,其中32耳(41.56%)气骨导差≤10dB(闭合)。随访5～25年,听力稳定的有67耳,听力下降4耳(均为镫骨提高术患者,再次手术后听力均有提高),听力较术后进一步提高的有28耳。结论镫骨手术是治疗耳硬化症的有效手段,也是治疗晚期耳硬化症或极晚期耳硬化症的有效方法之一。镫骨手术对改善晚期耳硬化症或极晚期耳硬化症患者的听力有较大帮助。
Objective To investigate the effect of tarsal surgery on the treatment of advanced otosclerosis. Methods A total of 300 cases of otosclerosis were randomly selected from 1970 to 1999. The patients with otoconjunctival otitis media who met the criteria of advanced otosclerosis [500 ~ 2000Hz mean bone conduction hearing threshold (audiometric grade, the same below) ≥40dB, mean airway hearing threshold ≥70dB Sexual deafness] 68 cases (77 ears) were retrospectively analyzed. Results The average hearing threshold of pure tone at 500 ~ 2000Hz after the operation of 68 patients (77 ears) was decreased from 77.32dB to 53.70dB before operation, which was 23.62dB (71.22dB) ≥10dB, of which 46 ears (59.74%) were closed. The average hearing threshold of 500-4000 Hz pure tone decreased from 79.01 dB to 58.23 dB, increased by 20.78 dB. The improvement of air conduction was ≥10 dB in 68 ears (88.31%), and the difference of air conduction in 32 ears (41.56%) was less than or equal to 10 dB (closed). During follow-up of 5 to 25 years, there were 67 ears with stable hearing and 4 ears with hearing loss (all patients with tarsus enhancement improved hearing again after operation), and 28 ears were further improved after the operation. Conclusion Tarsus surgery is an effective method for the treatment of otosclerosis and is also an effective method for the treatment of advanced otosclerosis or very late otosclerosis. Tarsus surgery is of great help in improving the hearing of late-stage otosclerosis or very late-stage otosclerosis.