Endolymphatic sac surgery in congenital malformations of the inner ear
Endolymphatic sac surgery in congenital malformations of the inner ear
复制标题
内淋巴囊手术治疗内耳先天畸形
DOI：
10.1288/00005537-198807000-00002
复制
发表时间：
1988
期刊：
影响因子：
--
通讯作者：
E. Monsell
中科院分区：
文献类型：
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作者：
R. Jackler;W. Luxford;D. Brackmann;E. Monsell
对40例（49耳）先天性进行性感音神经性听力损失患者行内淋巴囊手术进行回顾性分析。57%的手术耳内耳影像学异常。在其余的病例中，怀疑有细微的畸形，超出了放射学研究的分辨能力。29%的手术耳（14/49）发现术后早期听力损失（定义为三音平均听力损失>0 dB或言语辨别评分损失>15%）。然而，这些患者中只有2人在术后失去了所有的残余听力（2/49或4%）。50%的术后听力损失明显的患者在手术中发现了增大的内淋巴囊。对22例双侧内耳病理患者的长期听力稳定性进行了评估，这些患者只接受了一侧手术。对手术和未手术耳朵的听力命运的比较表明，与疾病的自然史相比，手术干预没有任何好处。基于这一经验，不再推荐先天性内耳畸形患者采用内淋巴囊手术来达到听力稳定的目的。
A retrospective analysis of 40 patients (49 ears) with congenital progressive sensorineural hearing loss who underwent endolymphatic sac surgery was performed. The inner ears were radiographically abnormal in 57% of operated ears. In the remaining cases, subtle malformations beyond the resolving power of radiographic studies were suspected. Early postsurgical hearing loss (defined as a loss >10 dB in three‐tone average or >15% in speech discrimination score) was found in 29% of operated ears (14/49). However, only two of these patients lost all of their residual hearing postoperatively (2/49 or 4%). An enlarged endolymphatic sac was noted at surgery in 50% of those with significant postoperative hearing losses. Longer‐term stability of hearing was assessed in 22 patients with bilateral inner‐ear pathology who underwent surgery on one side only. A comparison of the hearing fate of the operated and nonoperated ears suggested no benefit from the surgical intervention when compared to the natural history of the disease. Based upon this experience, endolymphatic sac surgery for the purpose of hearing stabilization in patients with congenital malformations of the inner ear is no longer recommended.