Long-Term Surgical Outcome of Canal-Tympanoplasty in Patients With Schuknecht Type B Congenital Aural Stenosis.

IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY
Yoonjae Lee, Moo Kyun Park, Jun Ho Lee, Sang-Yeon Lee, Myung-Whan Suh
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引用次数: 0

Abstract

Objectives: Congenital aural atresia (CAA) is a complex condition that manifests in various forms, including Schuknecht type B stenosis, which is characterized by a congenitally narrow bony external auditory canal (EAC). This study aims to evaluate the long-term surgical outcomes of canal-tympanoplasty in patients with Schuknecht type B CAA.

Methods: The study included 21 ears diagnosed with Schuknecht type B CAA, all of which underwent canal-tympanoplasty. Reconstruction of the large EAC and tympanic membrane involved conchal flap meatoplasty, bony EAC drilling, ossicular reconstruction, and overlay tympanoplasty. Standard pure-tone audiometry was analyzed at multiple post-surgery time points: 3, 6, 12, and 24-60 months. Additionally, the incidence of postoperative complications was assessed.

Results: The hearing outcomes of canal-tympanoplasty in this case series were satisfactory. Serviceable hearing was achieved in all patients after 3 months and was maintained in 85% of patients for 1 year. The air-bone gap improved from a preoperative average of 39.3±15.1 dB to 13.7±7.4 dB at 3 months, 16.4±10.5 dB at 6 months, 19.1±11.7 dB at 12 months, and 21.5±16.1 dB at 2-5 years postoperatively. Three patients required revision canal-tympanoplasty due to hearing deterioration, representing 14.3% of the cases. There were no instances of postoperative infection, facial nerve weakness, vertigo, deterioration of bone conduction thresholds, or complete restenosis of the EAC.

Conclusion: Canal-tympanoplasty proved to be a satisfactory surgical intervention for patients with Schuknecht type B CAA. This procedure led to significant improvements in hearing outcomes, providing serviceable hearing that lasted for several years. Moreover, the risk of postoperative hearing deterioration and/or the need for revision surgery within 1 year was considered acceptable.

Schuknecht B型先天性耳廓狭窄患者耳道鼓室成形术的远期疗效。
背景:先天性耳闭锁(CAA)是一种复杂的疾病,可以表现为多种形式,包括Schuknecht B型狭窄,其特征是先天性骨外耳道狭窄(EAC)。本研究旨在评价B型CAA患者行导管鼓室成形术的远期手术效果。方法:本研究纳入21只诊断为B型CAA并行导管鼓室成形术的耳。采用耳廓皮瓣肉成形术、骨性耳廓钻孔、听骨重建及覆盖鼓室成形术重建大耳廓及鼓膜。在术后3、6、12和24-60个月的不同时间点分析标准纯音听力学。评估术后并发症的发生率。结果:本病例行耳道鼓室成形术,听力效果满意。所有患者在3个月后均可获得听力,85%的患者可维持1年。气骨间隙(ABG)由术前的39.3±15.1 dB改善至3个月时的13.7±7.4 dB, 6个月时的16.4±10.5 dB, 12个月时的19.1±11.7 dB,术后2-5年时的21.5±16.1 dB。3例(14.3%)患者因听力恶化行耳道-鼓室修补术。无术后感染、面神经无力、眩晕、骨传导阈值恶化或EAC完全再狭窄病例。结论:对于CAA Schuknecht b型患者,耳道鼓室成形术是一种令人满意的手术干预,该手术可显著改善听力结果,持续数年的可使用听力。术后1年内听力下降和/或翻修手术的风险是可以接受的。
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来源期刊
CiteScore
4.90
自引率
6.70%
发文量
49
审稿时长
6-12 weeks
期刊介绍: Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.
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