引用本文:王 涛,唐凤珠,瞿申红,周 凯,叶林松,唐 杰,桂 志.耳硬化症术后听力预后因素分析[J].中国临床新医学,2019,12(9):946-949.
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耳硬化症术后听力预后因素分析
王 涛,唐凤珠,瞿申红,周 凯,叶林松,唐 杰,桂 志
530021 南宁,广西壮族自治区人民医院耳鼻咽喉头颈科(王 涛,唐凤珠,瞿申红,周 凯,叶林松,唐 杰,桂 志);530021 南宁,广西医科大学研究生院(周 凯)
摘要:
[摘要] 目的 分析影响耳硬化症患者术后听力预后的因素。方法 回顾性分析2010 06~2018 06在该科接受镫骨手术的耳硬化症患者112例的临床病历资料。收集的数据包括患者的人口学信息、临床特征、术前和术后听力数据、术前气骨导差(ABG)的大小。根据术后听力结果将患者分为优良组(术后ABG≤10 dB HL)83例和不良组(术后ABG>10 dB HL)29例。通过Logistic回归分析评估影响术后听力结果的因素。以ROC曲线法分析ABG对患者术后听力恢复的预测价值。结果 两组在年龄、性别、患侧方面比较差异无统计学意义(P>0.05)。优良组的术前气导(AC)阈值和术前ABG显著低于不良组(P<0.01)。两组术前、术后骨导(BC)阈值比较差异无统计学意义(P>0.05)。发现预后良好的术前ABG临界阈值为35.7 dB HL。结论 术前AC阈值和大ABG是影响耳硬化症患者预后的因素。术前小ABG和术前ABG<35.7 dB HL的患者的预后相似。术前ABG临界值<35.7 dB HL是预测耳硬化症手术成功的参数,在临床实践中有指导意义。
关键词:  耳硬化症  预后  听力
DOI:10.3969/j.issn.1674-3806.2019.09.04
分类号:R 764.32
基金项目:国家自然科学基金资助项目(编号:81960186);广西科技厅重点研发项目(编号:桂科AB17292089,桂科AB1850010);广西自然科学基金资助项目(编号:2017GXNSFAA198013);广西医疗卫生适宜技术开发与推广应用项目(编号:S2017078,S2018039);广西卫健委科研课题(编号:Z20170366)
Prognostic factors of the postoperative hearing in patients with otosclerosis
WANG Tao, TANG Feng-zhu, QU Shen-hong, et al.
Department of Otorhinolaryngology-Head and Neck, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To analyze the factors affecting the postoperative hearing improvements of the patients with otosclerosis. Methods The case data of 112 patients with otosclerosis who underwent stapes surgery at our department from June 2010 to June 2018 were retrospectively analyzed. The collected data included the patients′ demographics, clinical characteristics, pre- and postoperative audiometric data,size of preoperative air-bone gap(ABG). The patients were divided into two groups according to the postoperative hearing outcomes: excellent group(the patients with a postoperative ABG ≤10 dB HL, n=83) and poor prognosis group(the patients with a postoperative ABG >10 dB HL, n=29). Logistic regression analysis was performed to evaluate the factors affecting the postoperative hearing outcomes. The value of ABG in predicting postoperative hearing recovery was analyzed by receiver operating characteristics(ROC) curve. Results There were no statistically significant differences between the two groups in age, gender and the affected side(P>0.05). The mean preoperative air conduction(AC) threshold and preoperative ABG in the excellent group were significantly lower than those in the poor prognosis group(P<0.01). There was no statistically significant difference in the preoperative and postoperative bone conduction(BC) threshold between the two groups(P>0.05). The preoperative ABG cut-off threshold for the patients with good prognosis was 35.7 dB HL. Conclusion The preoperative AC threshold and large ABG are poor prognostic factors for the patients with otosclerosis. The functional outcomes in the patients with a preoperative small ABG were similar to those with a preoperative ABG <35.7 dB HL. A preoperative ABG cut-off value <35.7 dB HL might serve as a parameter for predicting surgical success in otosclerosis and seems to be useful in clinical practice.
Key words:  Otosclerosis  Prognosis  Hearing