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題 名 | 外耳正常之先天性聽小骨異常=Congenital Ossicular Anomalies in Patients with a Normal External Ear |
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作 者 | 黃德種; 洪朝明; 王拔群; 林俊成; 王仁鵬; 張敬驩; 陳威璋; | 書刊名 | 中華民國耳鼻喉科醫學雜誌 |
卷 期 | 34:5 民88.09-10 |
頁 次 | 頁389-393 |
分類號 | 416.812 |
關鍵詞 | 先天性聽小骨異常; 傳導性聽障; 聽小骨重建; 鰓弓; Congenital ossicular anomaly; Conductive deafness; Ossicular chain reconstruction; Branchial arch; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:先天性聽小骨異常多合併有外耳異常,較少見於外耳正常者。病患聽力可 藉由手術治療而獲得改善。然而術前並不易診斷,需進行鼓室探查術才可確定。 方法:本科自1991年至1997年間,共有8例無外耳異常之傳等性聽障患者,在本科接受鼓室 探查術,於術中發現聽小骨異常。整理病史、聽力學檢查及手術發現,並分析手術後聽力 結果,將資料提出報告。 結果:8名病患平均年齡22歲,男女各4名,術前氣骨差間距平均為39dB,各例於術中均執 行聽力重建。3例為鐙骨異常併足板固定,接受鐙骨切除術及人工鐙植入;1例為砧骨骼缺 失,接受異體砧骨插位術;另4例為砧骨長突缺失併鐙骨異常,接受全聽小骨置換物植入。 術後聽力改善約有6耳,氣差間距從平均41dB,進步到24.7 dB。 結論:一般的觀念中,槌骨和砧骨源自第一鰓弓,而鐙骨源自第二鰓弓。從本報告的術中 發現,可推論槌骨源自第一鰓弓,而部分之砧骨與鐙骨有相同來源,源自第二鰓弓。患者 接受手術治療,其手術後聽力改善程度,視異常種類及聽小骨重建方式而有差異。 |
英文摘要 | Background: Anomalies of the ossicies are commonly encountered in patients with a congenital anomaly of the external ear, and less frequently in patients with a normal external ear with a patent external meatus. Improvement of hearing can be achieved by surgical treatment. Methods: Surgery was performed on 8 ears from 8 patients with conductive hearing impairment without malformation of the external ear between 1991 and 1997. The following data were collected: the otological history, pre- and postoperative audiograms, intraoperative findings, and types of ossicular chain reconstruction. Results: There were 4 men and 4 women, with an average age of 22 years. The average preoperative air-bone gap was 39 dB. Ossicular chain reconstruction was performed during surgery. Three cases were found with stapes anomalies and footplate fixation, and a stapedectomy with piston-wire prosthesis was performed. One patient had a missing incus body and was treated with homograft incus interposition. The other 4 patients had stapes anomalies and missing incus long processes. They were given a total ossicular replacement prosthesis. Six patients had improved hearing. Their average postoperative air-bone gap was 24.7 dB compared to 41 dB preoperatively. Conclusions: The general opinion is that the maileus and the incus are derived from the first branchial arch, whereas the stapes is derived from the second. The pattern of ossicular abnormality encountered in this series suggests that the whole malleus originates from the first bronchial arch, while a part of the incus has the same origin as the stapes, the second branchial arch. The postoperative results depend on types of anomaly and surgery. |
本系統中英文摘要資訊取自各篇刊載內容。