【摘要】：目的：探討鈦聽骨在鼓室成形術(shù)中應(yīng)用效果，觀察術(shù)后聽力改善及并發(fā)癥情況。 方法：通過回顧性總結(jié)2010年10月至2011年12月我科收治的使用鈦聽骨行鼓室成形術(shù)的患者25例（25耳），與曾就診于我科使用自體骨的19例（19耳）作為對照組，所有病例具有完整隨訪資料。其中慢性化膿性中耳炎骨瘍型23耳（鈦聽骨10耳、自體骨13耳）、膽脂瘤型中耳炎12耳（鈦聽骨10耳、自體骨2耳）和鼓室硬化9耳（鈦聽骨5耳、自體骨4耳），，左耳24例，右耳20例，男性19耳，女性25耳，年齡分布9～68歲。自體骨較多使用的是自體砧骨（10耳），自體錘骨頭（4耳），外耳道上棘皮質(zhì)骨（5耳）。鈦聽骨來源于美國Medtonic Xomed公司和德國SPIGGLETHEIS公司，使用鈦聽骨PORP19耳和TORP6耳。以兩種手術(shù)方式：聯(lián)合徑路鼓室成形術(shù)和不伴乳突切開的鼓室成形術(shù)。對兩組間性別構(gòu)成、鼓膜愈合率、術(shù)式有無差別、術(shù)后短期并發(fā)癥、聽力提高效果進(jìn)行對比分析。 結(jié)果：（1）兩組患者性別構(gòu)成無差異。（2）鈦聽骨組與自體骨組術(shù)后鼓膜愈合率無組間差異。（3）無論植入何種聽骨材料，兩種手術(shù)方法術(shù)前、術(shù)后ABG無組間差別。（4）鈦聽骨與自體骨兩組術(shù)前、術(shù)后ABG無組間差別。（5）聽力提高程度在三種類型中耳疾病之間無差別。（6）鈦聽骨與自體骨兩組術(shù)后并發(fā)癥發(fā)生率無明顯差異。 結(jié)論：（1）使用自體骨和鈦質(zhì)人工聽骨重建聽骨鏈，生物相容性好，無排斥反應(yīng)，傳音功能好，成功率高。（2）自體骨取材方便，短期內(nèi)不易被吸收，但磨制耗時(shí)，有遠(yuǎn)期組織變性、殘存病灶可能；鈦質(zhì)聽骨有不同長度、規(guī)格，使用方便，聽力提高幅度大，但是價(jià)格昂貴，增加了患者經(jīng)濟(jì)負(fù)擔(dān)。（3）鈦聽骨與自體骨在鼓室成形術(shù)中聽力改善無明顯差異。
[Abstract]:Objective: to investigate the effect of titanium ossicles in tympanoplasty and to observe the hearing improvement and complications after tympanoplasty. Methods: from October 2010 to December 2011, 25 patients (25 ears) underwent tympanoplasty with titanium ossicular ossicles in our department, and 19 patients (19 ears) who had been treated with autogenous bone in our department as the control group. All cases had complete follow-up data. Chronic suppurative otitis media in 23 ears (titanium ossicles in 10 ears, autogenous bone in 13 ears), cholesteatoma type in 12 ears (titanium ossicles in 10 ears, autogenous bone in 2 ears), tympanic sclerosis in 9 ears (titanium ossicles in 5 ears, autogenous bone in 4 ears), left ear in 24 cases. In the right ear, 19 ears were male and 25 ears were female. The age distribution was 9 years and 68 years old. Autogenous incus (10 ears), autogenous hammerhead (4 ears) and supraspinal cortical bone (5 ears) were more commonly used in the autogenous bone. Titanium ossicles were obtained from Medtonic Xomed company and SPIGGLETHEIS company in Germany. PORP19 ears and TORP6 ears were used in titanium ossicles. Two surgical methods were used: combined tympanoplasty and tympanoplasty without mastoidotomy. Sex composition, tympanic membrane healing rate, surgical operation, short-term complications and hearing improvement were compared between the two groups. Results: (1) there was no difference in sex composition between the two groups. (2) there was no difference in the healing rate of tympanic membrane between the titanium ossicular group and the autogenous bone group. (3) No matter what kind of ossicular material was implanted, the two methods of operation were used before the operation. There was no difference in postoperative ABG between the two groups. (4) preoperative titanium ossicular bone and autogenous bone, There was no significant difference in postoperative ABG. (5) there was no difference in the degree of hearing improvement among the three types of middle ear diseases. (6) there was no significant difference in the incidence of postoperative complications between titanium ossicular bone and autogenous bone. Conclusion: (1) the autogenous bone and titanium artificial ossicular bone can be used to reconstruct the ossicular chain with good biocompatibility, no rejection, good sound transmission function and high success rate. (2) autogenous bone is easy to take and is not easy to be absorbed in the short term, but the grinding time is time consuming. There are long-term tissue degeneration, residual lesions may be; Titanium ossicles have different lengths, specifications, easy to use, large range of hearing improvement, but expensive, increasing the economic burden of patients. (3) there is no significant difference between titanium ossicles and autogenous ossicles in hearing improvement during tympanoplasty.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R764

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