[Analysis of the efficacy of fiber laser stapes fenestration in the treatment of 58 cases of otosclerosis and ossicular malformation].

Y N Zhang, S J Qiu, B Cao, Z Y Wei, Z S Shen
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Abstract

Objective: To explore the surgical efficacy of conductive deafness caused by otosclerosis and ossicular malformation with 980 nm fiber laser stapedial floor fenestration. Methods: Data of 58 patients (ears) who were diagnosed with conductive deafness caused by otosclerosis (49 ears) and ossicular malformation (9 ears) treated by 980 nm Diode laser small-fenestra stapedotomy were retrospectively analyzed. Air conduction (AC) thresholds, bone conduction (BC) thresholds, and air-bone gap (ABG) at 0.5, 1, 2, 4 kHz pure tone frequencies were compared before and 3 months after surgery, and the advantages and precautions of 980 nm fiber laser were summarized. Paired t-test (SPSS 26.0 software) was use to analyze the listening data. Results: Fiber optic laser stapes fenestration and artificial stapes implantation were successfully completed in all 57 cases (ears), the hearing of another one patient (ear) with floating malformation of detachment of stapedial floor was lower than that before surgery. Preoperative at 0.5, 1, 2, 4 kHz frequencies of AC thresholds, BC thresholds, and ABG were (65.4±9.7) dB, (27.2±8.9) dB, and (38.2±9.8) dB respectively. Postoperative 3 months at the same frequency of AC thresholds, BC thresholds, and ABG were (42.1±11.3) dB, (26.9±6.6) dB, and (15.2±9.1) dB. Preoperative and postoperative of AC threshold and ABG were statistically significant at 0.5, 1, 2, 4 kHz (t value was 13.270 and13.948, both P<0.01), and yet the BC threshold was not statistically significant before and after surgery at the same frequency (t=0.418, P>0.05). Conclusions: 980 nm fiber laser stapes floor fenestration is an effective treatment for conductive deafness caused by otosclerosis and ossicular malformation.

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[纤维激光镫骨瘘管术治疗 58 例耳硬化症和听骨畸形的疗效分析]。
目的探讨 980 nm 光纤激光镫骨底峡部手术治疗耳硬化症和听骨畸形引起的传导性耳聋的疗效。手术方法回顾性分析 58 例(耳)患者的数据,这些患者被诊断为耳硬化症引起的传导性耳聋(49 例)和听骨畸形(9 例),采用 980 nm 二极管激光小灶台镫骨切除术进行治疗。比较了手术前和手术后 3 个月在 0.5、1、2、4 kHz 纯音频率下的气导(AC)阈值、骨导(BC)阈值和气骨间隙(ABG),并总结了 980 nm 光纤激光的优点和注意事项。采用配对 t 检验(SPSS 26.0 软件)分析听力数据。结果57例(耳)患者均成功完成了光纤激光镫骨开窗术和人工镫骨植入术,另有1例(耳)镫骨底脱落浮动畸形患者的听力低于术前。术前在 0.5、1、2、4 kHz 频率下,AC阈值、BC阈值和 ABG 分别为 (65.4±9.7) dB、(27.2±8.9) dB 和 (38.2±9.8) dB。术后 3 个月,在相同频率下,AC阈值、BC阈值和 ABG 分别为(42.1±11.3)dB、(26.9±6.6)dB 和(15.2±9.1)dB。术前和术后交流阈和 ABG 在 0.5、1、2、4 kHz 时均有统计学意义(t 值分别为 13.270 和 13.948,Pt 均=0.418,P>0.05)。结论980 nm光纤激光镫骨底瓣成形术是治疗耳硬化症和听骨畸形引起的传导性耳聋的有效方法。
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