钛质人工听骨在手术治疗慢性化脓性中耳炎中的应用效果分析

Analysis on application effect of titanium artificial ossicle in operatively treating chronic suppurative otitis media

目的观察钛质人工听骨材料在慢性化脓性中耳炎术后的疗效及时间规律。方法选取该院2011年1月至2015年10月收治的慢性化脓性中耳炎且行乳突开放术、人工听骨植入术联合鼓室成形术患者106例,术后随访12个月,比较患者术前,术后1、6、12个月的气导听力、骨导听力及气骨导差,并观察患者鼓膜生长情况、主观听力恢复情况及对手术的满意程度。结果术后1个月患者气导听力与术前比较,差异无统计学意义(P>0.05);术后6、12个月患者气导听力较术前明显提升,差异均有统计学意义(P<0.05)。术后1、6、12个月气骨导差小于20 d B例数分别为12、64、67例。术后随着时间推移患者主观听力及对手术满意程度持续上升。结论钛质人工听骨材料的应用使慢性化脓性中耳炎患者术后听力得到明显提升,但人工听骨植入术后恢复时间长,术前需告知患者,术后需做好患者的心理辅导工作,以达到最佳的疗效。

Objective To investigate the postoperative curative effect and time rule of titanium artificial ossicular material in chronic suppurative otitis media. Methods One hundred and six patients with chronic suppurative otitis media treated by radical mastoidectomy, artificial ossicular implantation and myringoplasty in our hospital from January 2011 to October 2015 were selected and followed up for 12 months after operation. The air conduction hearing, knochenleitung and air-bone conduction gap were compared among preoperation, at postoperative 1,6,12 mouths. The eardrums growth situation, subjective hearing recovery and operation satisfaction degree were observed. Results There was no statistical difference in air conduction hearing between pre-operation and at 1 month after operation （P〉0.05） ;the air conduction hearing at postoperative 6,12 months was significantly increased compared with before operation, the difference was statistically significant （P〈0.05）. The cases number of air-bone con- duction gap less than 20 dB at postoperative 1,6,12 months were 12,64,67 cases. The subjective hearing and satisfaction to operation were continuously elevated with time elapse. Conclusion The application of titanium artificial ossicular material makes the postoperative hearing to obviously increase in the patients with chronic suppurative otitis media. But the recovery time is long after artificial ossicular implantation, which needs to inform the patients before operation, and the psychological counseling work after operation should be done well in order to reach the maximal curative effect.