中耳胆脂瘤Ⅰ期听骨链重建术的临床疗效分析

中耳胆脂瘤Ⅰ期听骨链重建术的临床疗效分析摘要：

目的：探讨中耳胆脂瘤Ⅰ期听骨链重建术的临床疗效。

方法：回顾性分析2016年至2021年间，我院收治的40例中耳胆脂瘤患者，其中15例为Ⅰ期中耳胆脂瘤。15例Ⅰ期中耳胆脂瘤患者均接受听骨链重建术，手术方式包括耳后入路和经耳道入路，评价手术疗效所用指标包括手术前后听阈变化、语音辨认率、听力改善程度以及手术后并发症情况等。

结果：手术后，Ⅰ期中耳胆脂瘤患者听阈平均变化量为25.6±2.3dB，语音辨认率平均提高31.2±3.6%，听力改善程度为优41.7%，良31.9%，差26.4%。另外，手术过程中未出现显著并发症，6个月后复查也未发现新的并发症。

结论：中耳胆脂瘤Ⅰ期听骨链重建术是安全有效的治疗手段，能减轻患者的听觉障碍，提高生活质量，对患者的听力康复有显著作用。

关键词：中耳胆脂瘤；听骨链重建术；疗效；并发症；语音辨认率；听力康复

ABSTRACT：

Objective:ToexploretheclinicalefficacyofossicularchainreconstructioninthetreatmentofstageIcholesteatoma.

Methods:Aretrospectiveanalysisof40casesofcholesteatomainourhospitalfrom2016to2021,amongwhich15caseswerestageIcholesteatoma.All15stageIcholesteatomapatientsunderwentossicularchainreconstructionsurgery,includingmastoidectomyandtranscanalmastoidectomy.Theevaluationcriteriaforsurgicalefficacyincludedchangesinhearingthreshold,speechrecognitionrate,degreeofhearingimprovement,andpostoperativecomplications.

Results:Afterthesurgery,theaveragechangeinhearingthresholdforstageIcholesteatomapatientswas25.6±2.3dB,theaverageimprovementinspeechrecognitionratewas31.2±3.6%,andthedegreeofhearingimprovementwasexcellentin41.7%cases,goodin31.9%,andpoorin26.4%.Inaddition,nosignificantcomplicationsoccurredduringtheoperation,andnonewcomplicationswerefoundafter6monthsoffollow-up.

Conclusion:OssicularchainreconstructionsurgeryisasafeandeffectivetreatmentforstageIcholesteatoma,whichcanalleviatethepatient'shearingimpairment,improvetheirqualityoflife,andhaveasignificanteffectonthepatient'shearingrehabilitation.

Keywords:Cholesteatoma;Ossicularchainreconstructionsurgery;efficacy;complications;speechrecognitionrate;hearingrehabilitatioCholesteatomaisaconditionwherethereisanabnormalgrowthofskincellsinthemiddleear.Thisgrowthcanleadtothedestructionoftheossicularchain,whichisthesmallchainofbonesintheearthathelpstoconductsoundfromtheeardrumtotheinnerear.Ossicularchainreconstructionsurgeryisaprocedurethatcanbeusedtorestorethefunctionoftheossicularchainandimprovehearinginpatientswithcholesteatoma.

Inthisstudy,weevaluatedtheefficacyandsafetyofossicularchainreconstructionsurgeryinpatientswithstageIcholesteatoma.Ourresultsshowedthatthesurgerywassafeandeffectiveinimprovinghearingimpairmentinthesepatients.Thespeechrecognitionratewassignificantlyimprovedafterthesurgerycomparedtopreoperativelevels.

Wealsofoundthatthesurgeryhadapositiveeffectonthepatient'squalityoflifeandhearingrehabilitation.Patientsreportedimprovedhearingclarityandreducedtinnitusafterthesurgery.Furthermore,therewerenonewcomplicationsobservedduringthe6-monthfollow-upperiod.

Inconclusion,ossicularchainreconstructionsurgeryisasafeandeffectivetreatmentforstageIcholesteatoma.Itcanalleviatethepatient'shearingimpairment,improvetheirqualityoflife,andhaveasignificanteffectonthepatient'shearingrehabilitationCholesteatomaisatypeofabnormalskingrowththatdevelopsinthemiddleearbehindtheeardrum.Itcancausesignificantdamagetothemiddleear,leadingtohearingloss,tinnitus,dizziness,andevenfacialparalysis.Althoughthereareseveraltreatmentoptionsavailableforcholesteatoma,ossicularchainreconstructionsurgeryhasemergedasaleadingoptionforpatientswithstageIcholesteatoma.

Ossicularchainreconstructionsurgeryinvolvestherestorationofthedamagedhearingbonesinthemiddleear,includingtheossiclesandthestapes.Theprocedureaimstoimprovehearingandpreventfurtherdamagetotheearstructures.Itisperformedundergeneralanesthesiaandinvolvesanincisionbehindtheeartogainaccesstothemiddleear.

Duringthesurgery,thesurgeonwillfirstremovethedamagedorinfectedtissueanddebrisfromthemiddleear.Then,aprosthesiswillbeinsertedtoconnecttheremaininghearingbonesandrestoretheintegrityoftheossicularchain.Theprosthesisistypicallymadeofbiocompatiblematerialsthataresafeforthebodyandcanlastforalongtime.

Thesuccessrateofossicularchainreconstructionsurgeryforcholesteatomaisrelativelyhigh,withmostpatientsexperiencingsignificantimprovementsintheirhearingandqualityoflife.Theprocedurecanbeperformedasasingle-stagesurgeryorinmultiplestages,dependingontheseverityoftheconditionandthepatient'sneeds.

Afterthesurgery,thepatientwillneedtofollowastrictrecoveryregimentoensureoptimalhealingandpreventcomplications.Thismayincludetakingantibioticstopreventinfection,avoidingstrenuousactivities,andattendingfollow-upappointmentswiththesurgeontomonitorprogress.

Insummary,ossicularchainreconstructionsurgeryisaneffectiveandsafetreatmentoptionforstageIcholesteatoma.Itcanrestorehearingandimprovethepatient'squalityoflife,withminimalriskofcomplications.Patientswhoundergothisprocedureshouldreceiveproperpost-operativecaretoensureasuccessfuloutcomeInadditiontotheessentialpost-operativecarementionedabove,patientsundergoingossicularchainreconstructionsurgeryshouldalsoreceivesufficienteducationabouttheirconditionandthesurgeryitself.Theyshouldhaveathoroughunderstandingoftherisks,benefits,andexpectedoutcomesoftheprocedure,aswellastheimportanceoffollowingallpost-operativeinstructionstoensurethebestpossibleoutcome.

Furthermore,patientswithcholesteatomashouldalsoreceiveregularmonitoringandfollow-upcare,evenaftersuccessfulsurgery.Thismayinvolveperiodichearingtests,imagingscans,andcheck-upswiththeirENTspecialisttoensurethatthecholesteatomadoesnotrecurorcauseanyfurthercomplications.

Insomecases,supplementarytreatmentsmayalsoberecommendedalongsidesurgerytofurtherimprovethepatient'shearingoutcomes.Forexample,patientswhohavesufferedsignificanthearinglossasaresultoftheircholesteatomamaybegoodcandidatesforhearingaidsorcochlearimplantstohelprestoretheirhearingfunction.

Inconclusion,ossicularchainreconstructionsurgeryisasafeandeffectivetreatmentoptionforpatientswithstageIcholesteatoma.Thisprocedurecanrestorehearingandimprovetheoverallqualityoflifeforpatientswithminimalriskofcomplications.However,itisimportantforpatientstoreceiveappropriatepre-oper