背景：在听骨链损伤的治疗过程中，使用何种修复材料尚存在较大的争议。 目的：对比新型羟基磷灰石-骨形态发生蛋白复合人工听小骨与同种异体软骨听骨赝复物修复听骨链损伤的效果。 方法：将60例慢性中耳炎患者分为对照组和试验组，每组30例。两组患者均行鼓室成形、听骨链重建治疗，对照组采用同种异体软骨听骨赝复物修复，试验组采用新型羟基磷灰石-骨形态发生蛋白复合人工听小骨修复，治疗后随访12个月，对比两组修复效果。 结果与结论：①空气传导值与气骨间隙值：两组治疗后的空气传导值与气骨间隙值均较治疗前显著改善(P<0.05)，试验组治疗后的空气传导值较对照组改善更明显(P<0.05)；②植入物脱出率：试验组未发生植入物脱出，对照组3例发生植入物脱出；③听力提高情况：试验组28例听力得到提高，提高率为93%；对照组25例听力得到提高，提高率为83%，两组间听力提高率比较差异有显著性意义(P<0.05)；④结果表明：新型羟基磷灰石-骨形态发生蛋白复合人工听小骨修复听骨链损伤，可获得与同种异体骨听骨赝复合物类似的修复效果。%BACKGROUND:There is a great dispute on the choice of repair materials for ossicular chain damage. OBJECTIVE:To explore the effects of new hydroxyapatite-bone morphogenetic protein ossicular prosthesis versus al ogeneic cartilage ossicular prosthesis in patients with ossicular chain damage. METHODS:Sixty patients with chronic otitis media were equal y assigned into a control group and a test group. Two groups of patients underwent tympanoplasty and ossicular chain reconstruction with al ogeneic cartilage ossicular prosthesis or hydroxyapatite-bone morphogenetic protein ossicular prosthesis, respectively. Twelve months after surgery, fol ow-up results were compared between two groups. RESULTS AND CONCLUSION:Air conduction value and air-bone gap value were both improved significantly in the two groups after surgery (P<0.05), and especial y, the postoperative air conduction value was better in the test group than the control group (P<0.05). Implant detachment was found in three cases of the control group, whereas did not occur in the test group. Improved hearing was found in 28 cases in the test group with an improvement rate of 93%and 25 cases in the control group with an improvement rate of 83%. There was a significant difference in the hearing improvement between the two groups (P<0.05). Overal , two kinds of prostheses can share similar effects on the ossicular chain repair. Subject headings:Tympanoplasty;Otitis Media;Bone Morphogenetic Proteins;Tissue Engineering
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