{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:32:10Z","timestamp":1761647530294},"reference-count":27,"publisher":"Akademiai Kiado Zrt.","issue":"47","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,11,1]]},"abstract":"<jats:p>A vezet\u00e9ses hall\u00e1scs\u00f6kken\u00e9st okoz\u00f3 otoscleroticus stapesfixatio m\u0171t\u00e9ti megold\u00e1s\u00e1nak folyamatos fejl\u0151d\u00e9se az elm\u00falt f\u00e9l \u00e9vsz\u00e1zad egyik f\u00fclseb\u00e9szeti sikert\u00f6rt\u00e9nete. A stapedectomia, illetve parci\u00e1lis stapedectomia mellett manaps\u00e1g a stapedotomia is elterjedt m\u0171t\u00e9ti megold\u00e1snak tekinthet\u0151.<jats:italic>C\u00e9l:<\/jats:italic>A minim\u00e1lisan invaz\u00edv l\u00e9zerstapedotomia hazai bevezet\u00e9se, tapasztalatok szerz\u00e9se, valamint a m\u0171t\u00e9ti hall\u00e1seredm\u00e9nyek \u00e9s a posztoperat\u00edv komplik\u00e1ci\u00f3k elemz\u00e9se.<jats:italic>M\u00f3dszer:<\/jats:italic>A szerz\u0151k k\u00f6zlem\u00e9ny\u00fckben KTP-l\u00e9zerrel assziszt\u00e1lt, Nitinol-pisztonnal v\u00e9gzett 14 eset\u00fck kapcs\u00e1n ismertetik l\u00e9zerstapedotomi\u00e1kkal szerzett els\u0151 tapasztalataikat. 2006 m\u00e1rciusa \u00e9s 2007 \u00e1prilisa k\u00f6z\u00f6tt 11 n\u0151beteget \u00e9s 3 f\u00e9rfi beteget oper\u00e1ltak. A betegek \u00e1tlag\u00e9letkora 42,2 \u00e9v volt, 6 esetben bal, 8 esetben jobb f\u00fcl\u00f6n t\u00f6rt\u00e9nt a m\u0171t\u00e9t. A betegek \u00e1tlagos k\u00f6vet\u00e9si ideje 9 h\u00f3nap volt.<jats:italic>Eredm\u00e9nyek:<\/jats:italic>A posztoperat\u00edv audiogramok \u00e9rt\u00e9kel\u00e9sekor az 500\u20131000\u20132000\u20133000 Hz frekvenci\u00e1kat figyelembe v\u00e9ve a l\u00e9gvezet\u00e9s \u00e1tlagos javul\u00e1sa 21,5 dB volt. Ugyanezen frekvenci\u00e1kon a csontl\u00e9gk\u00f6z\u00e9rt\u00e9kek \u00e1tlagos javul\u00e1sa 18,7 dB volt. Kilenc h\u00f3nap \u00e1tlagos k\u00f6vet\u00e9si id\u0151 mellett az eddigi esetekben a m\u0171t\u00e9teket k\u00f6vet\u0151en a betegek 85%-\u00e1ban az \u00e1tlagos csontl\u00e9gk\u00f6z &lt; 10 dB, de valamennyi beteg eset\u00e9ben &lt; 20 dB. Az \u00e1tlagos l\u00e9gvezet\u00e9s \u00e9rt\u00e9ke egy beteg kiv\u00e9tel\u00e9vel &lt; 30 dB. Bels\u0151f\u00fcl-k\u00e1rosod\u00e1sra utal\u00f3, a magashang-frekvenci\u00e1kat \u00e9rint\u0151 csontvezet\u00e9ses roml\u00e1st, facialis paresist nem \u00e9szleltek.<jats:italic>K\u00f6vetkeztet\u00e9sek:<\/jats:italic>A szerz\u0151k tapasztalatai \u00e9s az irodalmi adatok alapj\u00e1n a Nitinol-pisztonnal v\u00e9gzett l\u00e9zerstapedotomi\u00e1knak sz\u00e1mos el\u0151ny\u00fck van: 1) a piszton hurk\u00e1nak h\u0151re aktiv\u00e1l\u00f3d\u00f3 mem\u00f3riaeffektusa kik\u00fcsz\u00f6b\u00f6li az incus hossz\u00fa sz\u00e1r\u00e1ra k\u00e9t ponton t\u00f6rt\u00e9n\u0151 r\u00e1szor\u00edt\u00e1s h\u00e1tr\u00e1nyait; 2) a posztoperat\u00edv sz\u00e9d\u00fcl\u00e9s m\u00e9rt\u00e9ke enyh\u00e9bb, id\u0151tartama r\u00f6videbb, ez\u00e9rt az \u00e1pol\u00e1si id\u0151 cs\u00f6kken; 3) a m\u0171t\u00e9t k\u00f6lts\u00e9ghat\u00e9kony, \u00e9s minim\u00e1lisan invaz\u00edv; 4) a l\u00e9zer alkalmaz\u00e1sa minim\u00e1lis cochlearis traum\u00e1t, v\u00e9rmentes k\u00f6rnyezetet biztos\u00edt; 5) a prot\u00e9zis migr\u00e1ci\u00f3ja kik\u00fcsz\u00f6b\u00f6lhet\u0151, k\u00f6r\u00fcl\u00f6tte a granul\u00e1ci\u00f3 m\u00e9rs\u00e9keltebb; 6) magas frekvenci\u00e1kon tart\u00f3san j\u00f3 hall\u00e1seredm\u00e9ny \u00e9rhet\u0151 el; 7) a komplik\u00e1ci\u00f3k s\u00falyoss\u00e1ga, gyakoris\u00e1ga cs\u00f6kken, ez\u00e9rt a technika j\u00f3 megold\u00e1s kev\u00e9sb\u00e9 gyakorlott operat\u0151r\u00f6k sz\u00e1m\u00e1ra is; 8) probl\u00e9m\u00e1s esetekben (arteria stapedialis jelenl\u00e9te, obliterativ otosclerosis, \u00fasz\u00f3 stapestalp, rendellenesen fut\u00f3 n. facialis a dob\u00fcregben, rev\u00edzi\u00f3s m\u0171t\u00e9tek) is alkalmazhat\u00f3; 9) a hall\u00e1seredm\u00e9nyek interindividu\u00e1lis k\u00fcl\u00f6nbs\u00e9ge kisebb. \u2013 Eddigi kedvez\u0151 tapasztalataik alapj\u00e1n a szerz\u0151k l\u00e9zerstapedotomi\u00e1n \u00e1tesettek hossz\u00fa t\u00e1v\u00fa k\u00f6vet\u00e9s\u00e9t tervezik nagyobb beteganyagon.<\/jats:p>","DOI":"10.1556\/oh.2007.28177","type":"journal-article","created":{"date-parts":[[2007,11,15]],"date-time":"2007-11-15T18:17:05Z","timestamp":1195150625000},"page":"2241-2247","source":"Crossref","is-referenced-by-count":4,"title":["Laser stapedotomy \u2013 the up-to-date solution of otosclerotic stapes fixation"],"prefix":"10.1556","volume":"148","author":[{"given":"Imre","family":"Gerlinger","sequence":"first","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"Bak\u00f3","sequence":"additional","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Istv\u00e1n","family":"Szanyi","sequence":"additional","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter","family":"M\u00f3ricz","sequence":"additional","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"R\u00e1th","sequence":"additional","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Lujber","sequence":"additional","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krisztina","family":"Moric","sequence":"additional","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f3zsef","family":"Pytel","sequence":"additional","affiliation":[{"name":"1 P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar F\u00fcl-orr-g\u00e9g\u00e9szeti \u00e9s Fej-nyakseb\u00e9szeti Klinika P\u00e9cs Munk\u00e1csy M. u. 2. 7621"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1177\/000348945806700403","volume":"67","year":"1958","journal-title":"Ann. 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