[Clinical application of transcanal endoscopic ear surgery in the diagnosis and treatment of conductive hearing loss with intact tympanic membrane].

• DOI: 10.13201/j.issn.2096-7993.2020.12.004
• Publication Date: 2020-12-01
• Authors: Zhiqiang Tan; Tao Peng; Bin Liu; Gangyong Miao; Meixiang Bu; En Zhou; Xuping Xiao; Keji Ling
• Keywords: Conductive hearing loss

Objective:To explore the clinical efficacy of transcanal endoscopic ear surgery in diagnosis and treatment conductive hearing loss with intact tympanic membrane. Method:The data 16 patients membrane were retrospectively analyzed. They diagnosed treated by surgery. Result:All exploratory tympanotomy, including 6 cases congenital middle anomalies, 5 cholesteatoma, 2 anomalies otosclerosis, 1 case traumatic ossicular chain disruption. During exploration surgery, different methods reconstruction applied according to intraoperative lesions. Among 14 cases（14 ears）, 7 underwent partial replacement prosthesis （PORP）, had total （TORP）, piston. The remaining did not undergot reconstruction. After operation, mean air-conductive threshold decreased from （61.7±6.5） dB HL （29.8±10.7） （P<0.01） ABG from（36.8±3.2） （10.7±6.9） （P<0.01）. cholesteatoma lesion resection without Due lack suitable Piston, fixed stapes perform No serious complications occured after operations. Conclusion:Transcanal was for It minimally invasive low complications, a good recovery reconstruction.目的：探讨经外耳道耳内镜手术诊治鼓膜完整的传导性聋的疗效。 方法：回顾性分析16例鼓膜完整的传导性聋患者的临床资料，所有患者均经外耳道耳内镜手术探查。 结果：16例患者经鼓室探查均明确诊断，先天性中耳畸形6例，先天性中耳胆脂瘤5例，先天性中耳胆脂瘤合并中耳畸形2例，耳硬化2例，外伤性听骨链中断1例。经外耳道耳内镜手术探查鼓室并根据术中情况行听力重建，14例（14耳）中植入PORP 7例，TORP 5例，Piston 2例，其余2例未行听力重建。术后14例患者平均气导听阈由术前的（61.7±6.5） HL下降到术后的（29.8±10.7） HL（P<0.01），平均气骨导差由术前的（36.8±3.2） HL下降到术后的（10.7±6.9） HL（P<0.01）。1例先天性中耳胆脂瘤合并中耳畸形患者仅切除病灶，未行听力重建；1例患者听骨链畸形，镫骨底板固定，术中因无合适听骨，未行人工听小骨植入。术后无严重并发症发生。 结论：经外耳道耳内镜手术适合鼓膜完整的传导性聋患者的诊治，该手术微创、并发症低，行听力重建后患者听力恢复较好。.