中文摘要：

目的探讨以自体砧骨重建听骨链的开放式IIIa型鼓室成形术的听力改善疗效。方法回顾性收集16例（16耳）因慢性化脓性中耳炎或胆脂瘤中耳炎接受开放式Ⅲa型鼓室成形术患者的临床资料,所有病例均采用自体砧骨进行听骨链重建。术后随访3-6个月,评估患者手术后听力改善情况,分析指标为手术前后言语频率的纯音听阈及气骨导差。结果所有均达到干耳。纯音气导听阈从术前的45.2到干耳。降至术后的30.6的干耳。纯音气导听阈（P〈0.05）。术前、术后气骨导差分别为33.1、术后7dB及19.8、术后7dB分别为从术前的析,其中气骨导差小于20dB者占62.5%（10/16）。结论在本组病例中,以自体砧骨行听骨链重建开放式Ⅲa型鼓室成形术,获得了较好的近期听力改善效果,其远期疗效有待于进一步观察。

英文摘要：

Objective Besides eradication of chronic middle ear disease, reconstruction of the sound conduction apparatus is a major goal of modern ear microsurgery. The present study is aimed to assess the utility of autologous incus in reconstruction of ossieular chain. Methods Data from 16 patients （16 ears） who underwent canal wall-down tympanoplasty with autologous incus for ossicular replacement （type IIIa tympanoplasty） were reviewed. Pre-and post-operative pure tone thresholds and air-bone gaps （ABGs） at speech frequencies （0.5, 1 and 2 kHz） were compared. Results The average air-conduction threshold was 45.2± 8.3 dB HL pre-operatively and decreased to 30.6±5.6 dB HL postoperatively within the 3 to 6 months follow-up （P0.05）. The av erages of ABGs decreased from 33.13 dB HL pre-operatively and dec 4.9 dB postoperatively （P0.05）. Hearing reconstruction was considered successful in 62.5% of cases in which the averages postoperative ABGs were less than 20 dB. Conclusion Canal wall-down tympanoplasty with autologous incus for ossicular replacement can produce satisfactory hearing reconstruction outcomes based on our data. Long-term effects are yet to be determined.