【摘要】 目的 評價聚四氟乙烯人工聽骨在慢性中耳炎聽力重建中的應用效果。 方法 回顧性分析2008年8月〖CD3/5〗2009年12月慢性中耳炎手術中接受聚四氟乙烯部分/全人工聽骨贗復物(Partial/Total ossicular replacement prostheses,PORP/TORP,美國美敦力公司)行聽骨鏈重建的50例患者50只耳的臨床資料及隨訪結果。比較聽力學資料完整的39例39只耳手術前及手術后3～6個月語言頻率(05、1.0、2.0 kHz)氣導平均聽力及氣骨導差(airbonecap,ABG)。 結果 隨訪3～16個月,50只耳手術后1～3個月均干耳,手術后1個月鼓膜愈合良好。9只耳手術中人工聽骨表面未置入耳屏軟骨,其中1只耳手術后3個月人工聽骨脫出,1只耳手術后2個月鼓膜內陷,人工聽骨外端盤面外突。39只耳手術前氣導聽力為3667～9500 dB,平均為(5970±1433) dB;骨導聽力為330～5170 dB,平均為(2278±1161) dB;手術后氣導聽力平均為(4660±1703) dB,與手術前比較,差異有統計學意義(P lt;001)。手術前ABG為10～60 dB,平均為(3700±1212) dB。手術后ABG平均為(2620±1156) dB,與手術前比較,差異有統計學意義(P lt;001)。手術后氣導聽力提高1000～3000 dB者(手術后聽力提高有效)共24只耳,有效率為615%(24/39)。 結論 聚四氟乙烯人工聽骨是慢性中耳炎體重建聽骨的理想材料,手術后取得良好的聽力結果,遠期療效需進一步觀察。
【Abstract】 Objective To evaluate the effects of hearing reconstruction in chronic otitis meadia with prothesis. Methods Retrospective reviews were performed in 50 patients(50 ears)who had undergone Teflon Partial/Total ossicular replacement prostheses (PORP/TORP) implants from August 2008 to December 2009. Audiometric measurements (the average hearing threshold at 05, 10, 20 kHz) were taken in 39 patients (39 ears) preoperatively and postoperatively. Comparisons of preoperative and postoperative mean air condition and air bone gap (ABG) were performed. Results All patients were followed up for three to 16 months, and the surgery resulted in a dry ear and a healing drum without perforation in all 50 patients. Of the nine patients without tragus cartilage interposed between the drum and the prosthesis, one patient occured prothesis extrusion, and one patient had retraction of the eardrum. The mean air conduction of the 39 patients before and after surgery were (5970±1433) dB and (4660±1703) dB. The mean air bone gap (ABG) was (3700±1212) dB before operation, while it was elevated to (2620±1156) dB when followed up (P lt;001). The surgical treatments were found to be successful (postoperative mean air condition improved 10.0030.00 dB) in 24 ears (615%). The effectiveness was 615%. Conclution Teflon could be an ideal material for ossicular reconstruction in chronic otitis media, and the hearing improvement is obtained after operation, but the problem of extrusion has not been solved at present, and the longterm effects should be surveyed.

Citation： XIE Wen,ZHENG Yan.. Effects of Hearing Reconstruction by Teflon Prothesis in Chronic Otitis Media. West China Medical Journal, 2010, 25(4): 691-. doi: Copy

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