445 nm波长激光在慢性中耳炎手术治疗中的疗效
Efficacy of a 445 nm wavelength laser in the surgical treatment of chronic otitis media.
文献信息
| PMID | 42704464 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | David Leffers |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany. David.Leffers@uksh.de. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
假设： 使用蓝色波长激光的激光辅助中耳手术是治疗慢性中耳炎的充分治疗选择。
引言： 慢性中耳炎的根治性治疗需要完全清除所有炎症部位。基于激光的手术技术已显示出在彻底切除的同时保留听觉功能的潜力。本研究探讨了使用445 nm二极管激光相关的临床结局，特别是关于慢性中耳炎患者的复发率和术后听力恢复。
方法： 纳入53例因慢性中耳炎在吕贝克大学耳鼻咽喉医学科接受显微镜下中耳手术的患者队列（21例激光组，32例显微手术组），其适应证依据指南驱动。手术干预采用纤维引导方法，使用商用445 nm波长二极管激光进行组织消融，以脉冲模式操作，激光峰值功率高达4瓦，并与传统显微手术技术进行比较。进行回顾性分析以评估复发和听力学结局，通过气导和骨导阈值的纯音平均值进行评估。
结果： 术后六个月，二极管激光队列的患者在听力结局方面表现出显著改善，优于接受传统显微手术技术的患者（激光组中位AC-PTA从45.36 dB改善至30.67 dB，而显微手术组从43.48 dB至44.45 dB；p = 0.0163）。所有记录的复发均仅发生在显微手术治疗组内。
结论： 蓝激光辅助中耳手术是治疗慢性中耳炎的一种安全且有效的方式。
英文摘要
HYPOTHESIS: Laser-assisted middle ear surgery using a blue wavelength laser is a sufficient treatment option for chronic otitis media.
INTRODUCTION: Definitive treatment of chronic otitis media necessitates complete removal of all sites of inflammation. Laser-based surgical techniques have demonstrated promise for achieving thorough resection while preserving auditory function. This study examines the clinical outcomes associated with the use of a 445 nm diode laser, specifically regarding recurrence rates and postoperative hearing restoration in patients with chronic otitis media.
METHODS: A cohort of 53 patients (21 Laser respectively 32 microsurgical) undergoing microscopic middle ear surgery for chronic otitis media at the Department of Ear, Nose and Throat Medicine, University of Lübeck, was included based on guideline-driven indications. The surgical intervention employed a fiber-guided approach using a commercial 445 nm wavelength diode laser for tissue ablation, operated in pulse mode with a laser peak power of up to 4 Watt, compared to conventional microsurgical techniques. Retrospective analysis was performed to evaluate recurrence and audiometric outcomes, assessed via pure-tone averages for air and bone conduction thresholds.
RESULTS: Six months postoperatively, patients in the diode laser cohort exhibited a significant improvement in hearing outcomes compared to those treated with conventional microsurgical techniques (median AC-PTA improved from 45.36 dB to 30.67 dB in the laser group versus 43.48 dB to 44.45 dB in the microsurgical group; p = 0.0163). All documented recurrences occurred exclusively within the microsurgical treatment group.
CONCLUSION: Blue laser-assisted middle ear surgery represents a safe and efficacious modality for the management of chronic otitis media.