钛听骨在鼓室成形术中的应用

发布时间：2019-04-18 13:48

【摘要】：目的：探讨钛听骨在鼓室成形术中应用效果，观察术后听力改善及并发症情况。方法：通过回顾性总结2010年10月至2011年12月我科收治的使用钛听骨行鼓室成形术的患者25例（25耳），与曾就诊于我科使用自体骨的19例（19耳）作为对照组，所有病例具有完整随访资料。其中慢性化脓性中耳炎骨疡型23耳（钛听骨10耳、自体骨13耳）、胆脂瘤型中耳炎12耳（钛听骨10耳、自体骨2耳）和鼓室硬化9耳（钛听骨5耳、自体骨4耳），，左耳24例，右耳20例，男性19耳，女性25耳，年龄分布9～68岁。自体骨较多使用的是自体砧骨（10耳），自体锤骨头（4耳），外耳道上棘皮质骨（5耳）。钛听骨来源于美国Medtonic Xomed公司和德国SPIGGLETHEIS公司，使用钛听骨PORP19耳和TORP6耳。以两种手术方式：联合径路鼓室成形术和不伴乳突切开的鼓室成形术。对两组间性别构成、鼓膜愈合率、术式有无差别、术后短期并发症、听力提高效果进行对比分析。结果：（1）两组患者性别构成无差异。（2）钛听骨组与自体骨组术后鼓膜愈合率无组间差异。（3）无论植入何种听骨材料，两种手术方法术前、术后ABG无组间差别。（4）钛听骨与自体骨两组术前、术后ABG无组间差别。（5）听力提高程度在三种类型中耳疾病之间无差别。（6）钛听骨与自体骨两组术后并发症发生率无明显差异。结论：（1）使用自体骨和钛质人工听骨重建听骨链，生物相容性好，无排斥反应，传音功能好，成功率高。（2）自体骨取材方便，短期内不易被吸收，但磨制耗时，有远期组织变性、残存病灶可能；钛质听骨有不同长度、规格，使用方便，听力提高幅度大，但是价格昂贵，增加了患者经济负担。（3）钛听骨与自体骨在鼓室成形术中听力改善无明显差异。
[Abstract]:Objective: to investigate the effect of titanium ossicles in tympanoplasty and to observe the hearing improvement and complications after tympanoplasty. Methods: from October 2010 to December 2011, 25 patients (25 ears) underwent tympanoplasty with titanium ossicular ossicles in our department, and 19 patients (19 ears) who had been treated with autogenous bone in our department as the control group. All cases had complete follow-up data. Chronic suppurative otitis media in 23 ears (titanium ossicles in 10 ears, autogenous bone in 13 ears), cholesteatoma type in 12 ears (titanium ossicles in 10 ears, autogenous bone in 2 ears), tympanic sclerosis in 9 ears (titanium ossicles in 5 ears, autogenous bone in 4 ears), left ear in 24 cases. In the right ear, 19 ears were male and 25 ears were female. The age distribution was 9 years and 68 years old. Autogenous incus (10 ears), autogenous hammerhead (4 ears) and supraspinal cortical bone (5 ears) were more commonly used in the autogenous bone. Titanium ossicles were obtained from Medtonic Xomed company and SPIGGLETHEIS company in Germany. PORP19 ears and TORP6 ears were used in titanium ossicles. Two surgical methods were used: combined tympanoplasty and tympanoplasty without mastoidotomy. Sex composition, tympanic membrane healing rate, surgical operation, short-term complications and hearing improvement were compared between the two groups. Results: (1) there was no difference in sex composition between the two groups. (2) there was no difference in the healing rate of tympanic membrane between the titanium ossicular group and the autogenous bone group. (3) No matter what kind of ossicular material was implanted, the two methods of operation were used before the operation. There was no difference in postoperative ABG between the two groups. (4) preoperative titanium ossicular bone and autogenous bone, There was no significant difference in postoperative ABG. (5) there was no difference in the degree of hearing improvement among the three types of middle ear diseases. (6) there was no significant difference in the incidence of postoperative complications between titanium ossicular bone and autogenous bone. Conclusion: (1) the autogenous bone and titanium artificial ossicular bone can be used to reconstruct the ossicular chain with good biocompatibility, no rejection, good sound transmission function and high success rate. (2) autogenous bone is easy to take and is not easy to be absorbed in the short term, but the grinding time is time consuming. There are long-term tissue degeneration, residual lesions may be; Titanium ossicles have different lengths, specifications, easy to use, large range of hearing improvement, but expensive, increasing the economic burden of patients. (3) there is no significant difference between titanium ossicles and autogenous ossicles in hearing improvement during tympanoplasty.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R764

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