引用本文:霍冬冬,李 伟,李元叶.完壁式乳突切开鼓室成形术治疗慢性化脓性中耳炎患者术后听力改善的效果分析[J].中国临床新医学,2019,12(12):1296-1299.
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完壁式乳突切开鼓室成形术治疗慢性化脓性中耳炎患者术后听力改善的效果分析
霍冬冬,李 伟,李元叶
272000 山东,济宁市第一人民医院耳鼻咽喉头颈外科(霍冬冬,李 伟),感染管理部(李元叶)
摘要:
[摘要] 目的 探讨完壁式乳突切开鼓室成形术治疗慢性化脓性中耳炎患者术后听力改善效果,为临床治疗提供参考依据。方法 选择2015-05~2018-05在该院行完壁式乳突切开鼓室成形术治疗慢性化脓性中耳炎患者92例,术前均给予纯音听阈测定、声阻抗和颞骨CT等检查,术后3个月行纯音听阈测听检查,以纯音听阈测定结果作为听力功能评价指标。结果 与术前相比,患者术后气导听阈降低、骨导听阈上升、气骨导差缩减,差异有统计学意义(P<0.05)。在低频段(0.5~2.0 kHz),患者术后的骨导听阈与术前比较差异无统计学意义(P>0.05);在高频段(4.0~8.0 kHz),患者术后骨导听阈大于术前,差异有统计学意义(P<0.05)。患者听力改善显效75例(81.52%),有效12例(13.04%),无效5例(5.44%),总有效率为94.56%。结论 完壁式乳突切开鼓室成形术对慢性化脓性中耳炎患者听力治疗效果显著,但电钻噪音可造成高频区骨导听力下降。
关键词:  完壁式乳突切开  鼓室成形术  慢性化脓性中耳炎  治疗效果
DOI:10.3969/j.issn.1674-3806.2019.12.10
分类号:R 762
基金项目:山东省医药卫生科技发展计划项目(编号:2016WS0156)
Analysis of the effect of intact canal wall mastoidectomy plus tympanoplasty on hearing improvement of chronic suppurative otitis media
HUO Dong-dong, LI Wei, LI Yuan-ye
Department of Otorhinolaryngology-Head and Neck Surgery, Jining No.1 People′s Hospital, Shandong 272000, China
Abstract:
[Abstract] Objective To investigate hearing improvement in the patients with chronic suppurative otitis media after intact canal wall mastoidectomy plus tympanoplasty, and to provide reference for clinical treatment. Methods Ninety-two cases of chronic suppurative otitis media receiving intact canal wall mastoidectomy plus tympanoplasty were selected in our hospital from May 2015 to May 2018. All the patients were given pure tone audiometry, acoustic impedance and temporal bone CT examination before operation. Pure tone audiometry was performed 3 months after operation. The results of pure tone audiometry were used as the evaluation index of hearing function. Results Compared with those before operation, the patients′ postoperative air conduction threshold decreased significantly, and the bone conduction threshold increased significantly, and the reduction of air bone conduction decreased significantly(P<0.05). At the low frequency band(0.5~2.0 kHz), there were no significant differences between the preoperative and the postoperative bone conduction thresholds(P>0.05). At the high frequency band(4.0~8.0 kHz), the auditory threshold of bone conduction after operation was significantly higher than that before operation(P<0.05). Hearing improvement was markedly effective in 75 cases(81.52%), effective in 12 cases(13.04%) and ineffective in 5 cases(5.44%), and the total effective rate was 94.56%. Conclusion Intact canal wall mastoidectomy plus tympanoplasty has significant improvement effect on hearing in patients with chronic suppurative otitis media, but drill noise can cause hearing loss in high frequency area of bone conduction.
Key words:  Intact canal wall mastoidectomy  Tympanoplasty  Chronic suppurative otitis media  Treatment effect