Analysis of the long-term hearing results after the surgical repair of aural atresia
Analysis of the long-term hearing results after the surgical repair of aural atresia
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DOI：
10.1097/01.mlg.0000233703.52308.73
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发表时间：
2006-10-01
期刊：
影响因子：
2.6
通讯作者：
Hur, Dong Gu
中科院分区：
文献类型：
--
作者：
Chang, Sun O.;Yoon, Byung;Hur, Dong Gu
目标。仔细的手术候选人选择保证了先天性耳闭锁（CAA）患者术后听力恢复的高概率。作者分析了CAA术后长期随访的听力结果（F/U）与几个临床因素的关系。研究设计：这是一项回顾性研究。方法：回顾性分析1987年1月~ 2002年12月在汉城大学医院行CAA手术患者93例（100耳）的病历。平均持续时间为56.9个月。作者对术后3年以上的听力结果进行了评估，以澄清导致结果不成功的因素。结果：大约64%接受手术治疗的患者在长期F/U后获得了相当大的听力增益。术后听力在6个月至3年内保持相对稳定，仅出现2.75 dB的加重。然而，翻修病例的听力结果随着时间的推移而恶化，导致1年和3年F/Us时的空气传导阈值高于原发病例。结果，首次手术后听力恢复较差的患者中只有26.6%受益于听力学修复。发现小耳畸形的严重程度有助于预测CAA手术后不良的长期听力结果。结论：未翻修的病例和轻度小耳畸形的病例具有可接受和稳定的长期听力结果。在这些情况下，对于翻修后的长期听力结果令人失望，以及严重的小耳畸形病例，应考虑其他选择，例如骨锚定助听器，它提供可靠和稳定的结果。
Objectives. Careful surgical candidate selection guarantees a high probability of serviceable hearing postoperatively in congenital aural atresia (CAA) patients. The authors analyzed hearing results after CAA surgery with long-term follow-up (F/U) with respect to several clinical factors. Study Design: This was a retrospective study. Methods: The medical records of 93 CAA patients (100 ears) who underwent operations from January 1987 through December 2002 at Seoul National University Hospital were reviewed. Mean duration was 56.9 months. The authors evaluated the results of hearing after surgery over 3 year F/U with a view to clarifying the factors accounting for unsuccessful results. Results: Approximately 64% of patients treated surgically achieved a considerable hearing gain over long-term F/U. Postoperative hearing remained relatively stable over the period from 6 months to 3 years postoperatively, yielding only 2.75 dB of aggravation. However, hearing results in revision cases deteriorated with time, which led to statistically higher air-conduction thresholds than those of primary cases at the 1 and 3 year F/Us. Resultantly, only 26.6% of patients having achieved a poor hearing gain post first surgery benefited from revision audiologically. The severity of microtia was found to help predict poor long-term hearing outcomes after CAA surgery. Conclusions: Nonrevision cases and cases with mild microtia appear to have acceptable and stable long-term hearing results. Disappointing long-term hearing results in revision, and severe microtia cases should lead to considerations of alternative options in these cases, such as bone-anchored hearing aids, which offer reliable and stable results.