智能CO_2激光在耳硬化症手术中的应用

The Application of Intelligent CO_2 Laser in the Treatment of Otosclerosis

目的探讨应用智能CO_2激光辅助Fisch人工镫骨术治疗耳硬化症的疗效。方法回顾性分析28例接受智能CO_2激光辅助Fisch人工镫骨手术治疗的耳硬化症患者的临床资料,术中均使用智能CO_2激光切断镫骨肌腱、后足弓,并行镫骨足板开窗;所有患者术前及术后6个月行纯音听阈测试,记录0.5、1、2、4kHz频率气、骨导阈值。结果所有患者术后均未发生永久性眩晕和感音性聋;所有患者手术前后骨导阈值无明显变化,差异无统计学意义(P>0.05);术前及术后6个月言语频率气骨导差中位数分别为30.38(23.13,39.38)及9.75(8.25,10)dB,两者差异有统计学意义(P<0.05)。结论智能CO_2激光切断镫骨肌腱、后足弓,行镫骨足板开窗安全便捷,适合在耳硬化症人工镫骨手术中使用。

Objective To investigate the effects of the intellegent CO_2 laser assisted Fisch stapedotomy with artificial stape prostheses in the treatment of otosclerosis.Methods A total of 28 patients with otosclerosis who had undergone the intellegent CO_2 laser assisted Fisch stapedotomy with artificial stape prostheses were retrospectively evaluated.The intellegent CO_2 lasersare was used to vaporize stapedius tendon,posterior crus of stapes,and most importantly perforate stapes footplate.Bone and air conduction thresholds were determined at 0.5,1,2,and 4kHz preoperatively and 6months postoperatively in all patients.Results No sustained vertigo or sensorineural hearing loss occurred postoperatively.There were no statistically significant differences between preoperative and postoperative average bone conduction thresholds.Preoperative and postoperative air bone gap were 30.38（23.13,39.38）dB HL,9.75（8.25,10）dB respectively and the postoperative results were significantly different from the preoperative.Conclusion The intellegent CO_2 laser can be used safely in stapes footplate surgery and is well suited for treating otosclerosis.