早期中耳副神经节瘤的经耳道内镜切除术
Transcanal endoscopic excision of early-stage middle ear paragangliomas.
文献信息
| PMID | 42764285 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | İsa Kaya |
| 作者单位 | Department of Otorhinolaryngology, Ege University Faculty of Medicine, Izmir, Türkiye. |
| 期刊 | Acta oto-laryngologica |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 描述对早期中耳副神经节瘤行单纯经耳道内镜耳科手术（TEES）后患者层面的听力和症状结局。
方法： 本回顾性病例系列纳入2019年1月至2023年9月期间连续治疗的9例Glasscock-Jackson I-II期肿瘤患者。术前及6个月时评估气导（AC）和骨导（BC）纯音平均值及气骨导差（ABG）。AC纯音平均值下降至少10 dB定义为听力改善。
结果： 平均AC纯音平均值从52.3 ± 18.0 dB降至34.4 ± 15.0 dB，平均ABG从31.3 ± 8.0 dB降至13.0 ± 4.6 dB；平均BC纯音平均值保持稳定（21.0 ± 13.7 vs. 21.4 ± 13.4 dB）。8例患者改善，1例保持稳定，无1例恶化。8例患者存在搏动性耳鸣，均全部缓解。2处局限性鼓膜缺损以颞肌筋膜修复；两者均愈合，无延迟性穿孔。未发生中转手术、面神经功能障碍、输血或其他重大围手术期并发症。平均随访16.1 ± 7.9个月（范围10-36个月）后，未发现临床明显的残留或复发病变。
结论： 在这一经选择的病例系列中，单纯TEES提供了具有临床意义的传导性听力改善、稳定的BC阈值以及完全的耳鸣缓解。在需要时，即刻颞肌筋膜修复提供了持久的鼓膜闭合。
英文摘要
OBJECTIVE: To describe patient-level hearing and symptom outcomes after exclusive transcanal endoscopic ear surgery (TEES) for early-stage middle ear paragangliomas.
METHODS: This retrospective case series included nine consecutive patients with Glasscock-Jackson stage I-II tumors treated between January 2019 and September 2023. Air-conduction (AC) and bone-conduction (BC) pure-tone averages and air-bone gaps (ABGs) were assessed preoperatively and at 6 months. A decrease of at least 10 dB in AC pure-tone average defined hearing improvement.
RESULTS: Mean AC pure-tone average decreased from 52.3 ± 18.0 to 34.4 ± 15.0 dB and mean ABG from 31.3 ± 8.0 to 13.0 ± 4.6 dB; mean BC pure-tone average remained stable (21.0 ± 13.7 vs. 21.4 ± 13.4 dB). Eight patients improved, one remained stable, and none worsened. Pulsatile tinnitus was present in eight patients and resolved in all. Two limited tympanic membrane defects were repaired with temporalis fascia; both healed without delayed perforation. No conversion, facial nerve dysfunction, transfusion, or other major perioperative complication occurred. No clinically evident residual or recurrent disease was identified after a mean follow-up of 16.1 ± 7.9 months (range, 10-36 months).
CONCLUSION: Exclusive TEES provided clinically meaningful conductive hearing improvement, stable BC thresholds, and complete tinnitus resolution in this selected series. Immediate temporalis fascia repair provided durable membrane closure when needed.