鼓室硬化类型与手术疗效(附40例临床分析)

目的 探讨硬化灶累及中耳部位与术前听力损失类型的关系、不同手术方式治疗鼓室硬化症的效果。方法 回顾性分析40例鼓室硬化患者术前资料，术中病灶记录，评估术后听力改善水平。结果 传导性耳聋的病例中最常见病灶侵及上鼓室、锤砧关节周围，而混合性耳聋的病例中病灶累及鼓岬的概率明显高于传导性耳聋的病例。术后气骨导间距小于20dB 18耳，成功率40%，Ⅰ型鼓室硬化症术后听力改善最显著(P＜0.05)。结论 听力损失的性质与硬化灶的范围及累及中耳的部位直接相关。手术处理是治疗鼓室硬化症的主要手段，手术方式则根据病变累及的范围和程度决定。

Surgical outcomes of different types of tympanosclerosis (40 cases report)

Objective To study the relationship between the type of preoperative hearing loss and the site of tympanosclerosis, and analyze the effect of our surgical protocol for patients. Methods The preoperative features, sclerosis focus detected during surgery and hearing levels after surgery on tympanosclerosis were retrospectively summed up for 40 patients in our hospital from October 2005 to December 2009． Results While attic and the incudostapedial joint involvement are most frequently seen in conductivetype hearing loss, mixed type hearing loss isolated promontorium and involvement of the incudostapedial joint and around stapes are not seen.Post op outcome was found to be 40% in the patients with an air-bone gap between 0-20 dB.The best hearing result belonged to type 1 patients. Cases in which the stapes footplate was fixated had the worst result in terms of hearing. Conclusion There is a direct relationship between the type of preoperative hearing loss and the site of tympanosclerosis. Surgery is the main method for tympanosclerosis．The operation should be adapted to different areas and degrees of the sclerosis focus.