陶瓷听骨链的研究及临床应用

Study of Ceramic Ossicular Chain and Clinical Use

我们对自行研究的羟基磷酸钙烧结体听骨链(HA-听骨柱)进行了2年的动物实验观察,并根据光镜、电镜所获可靠结果,对51例慢性化脓性中耳炎患者施以听骨链重建术,术后随访长达2年多,语言频域气导稳定平均提高20～30dB(P-型听柱,76.3%),仅1例发生部分脱出,经2次修复完好,效果令人满意。对比文献报道,本研究有3方面显著特点,即:1、实验是在狗身上进行的;2、结合国人解剖特点制成2mm 长之听柱;3、术中使用 ZT 生物胶更有利用成形创面的粘膜作用。

As for implant material for reconstructive ear surgery,several kinds of ceramics are available.It is reported that there is significacete difference in the bioactivity among these materials.In orser to in- vestigate the behavior of HA (Hydroxyl apatite) in reconsrtuctive middle ear surgery,an experiment was perfommed on 8 dogs.The prosthesis was surgically implanted in the hypotympanum of animals. The results showed that biocomparibility of the HA-prosthesis might be satisfactory regarding the use of implant materials,since neither foreign body reaction nor absorption of the materials eas found in the specimens.Clinical application might be taken into construction according to these results.Ossicular reconstruction of middle ear by employing a HA-prosthsis was performed in 51 patients with chronic otitis media with or without cholosteatoma.50 ears were operated on to one-stage and one case in two- stage completion.Postoperative hearing results after 2 years of following up were assesed as follows: air-conduction hearing improved by 20-30 dB(P-type:76.3%),partial extrusion of the prosthesis oc- curred in only one patient.