CO_2激光辅助Fisch人工镫骨技术治疗耳硬化症疗效观察

The Effect of CO_2 Laser Assisted Stapedotomy with Artificial Stapes Prostheses on the Treatment of Otosclerosis

目的 探讨CO2激光辅助Fiseh人工镫骨技术治疗耳硬化症的疗效。方法 2001年10月至2003年12月间，30名临床确诊为耳硬化症的患者在上海交通大学附属第六人民医院接受CO2激光辅助Fiseh人工镫骨技术治疗，术前言语频率平均气导听阈为63．33dB HL，气骨导差为24．5～50．25dB，平均为36dB。全部病例随访12个月以上，平均随访18个月。结果 24例患者于术后6个月复查听力，言语频率平均气导听阈为26．82dB HL，气骨导差≤15dB者23例，占95．83％；气骨导差≤10dB者21例，占87．5％；平均气骨导差为8．50dB。30例患者术后12个月时复查听力，言语频率平均气导听阈为27．52dB乩，气骨导差≤15dB者28例，占93．33％；气骨导差≤10dB者25例，占83．33％；平均气骨导差为8．60dB。术后半年与一年复查听力结果相比，差异无统计学意义（P〉0．05）。结论 CO2激光辅助Fiseh人工镫骨技术治疗耳硬化症疗效显著，术后反应轻，远期疗效稳定，是治疗耳硬化症的可靠技术。

Objective To explore the outcomes of CO2 laser assisted Fisch stapedotomy with artificial stapes prostheses in the treatment of otosclerosis. Methods Between October 2001 and December 2003, 30 patients diagnosed with otosclerosis accepted CO2 laser assisted Fisch stapedetomy with artificial stapes prostheses at the Affiliated Sixth People＇s Hospital of Shanghai Jiaotong University. The averaged preoperative air conduction threshold of speech frequency was 63.33 dB HL, the air - bone gap of speech frequency was 24.5 to 50.25 dB, with an average of 36 dB. All cases were followed up for more than 12 months with an average of 18 months. Results Among the 30 cases, 24 cases accepted auditory follow up after 6 month postoperatively. The averaged postoperative air conduction threshold of speech frequency was 26.82 dB HL. Postoperative air - bone gap ≤ 15 dB was achieved in 23 cases（95.83 % ）and air- bone gap≤10 dB was achieved in 21 persons（87.5 % ）, with a mean of 8.50 dB. The averaged postoperative air conduction threshold of speech frequency was 27.52 dB HL 12 months postoperatively. Air - bone gap of speech frequency ≤ 15 dB was achieved in 28 cases（93.3%）and air- bone gap of speech frequency≤10 dB was achieved in 25 cases（83.33%）, with an average of 8.60 dB. There were no statistical significance between the outcomes 6 months and 12 months postoperatived（ P 〉 0. 05）. Conclusion CO2 laser assisted stapedotomy is a reliable surgical technique for treating otosclerosis. This procedure has the significant effectiveness, and can achive stable outcomes, but with slight postoperative complication.