慢性化脓性中耳炎骨导听力下降的影响因素分析

目的探讨引起慢性化脓性中耳炎骨导听阈提高的因素。方法回顾性分析240例单侧慢性化脓性中耳炎患者的临床资料,对语频区和4.0kHz骨导听力与听骨链、胆脂瘤、鼓膜穿孔的情况作统计学分析。结果患耳与健耳骨导听力阈值之间差异有统计学意义。听骨链破坏和鼓膜穿孔的部位对骨导听阈有一定的影响。结论慢性化脓性中耳炎可引起骨导听力下降。部分患者是由于中耳病变所致,因此积极的治疗可能提高患者的骨导听力。     

122例慢性化脓性中耳炎患者术前骨导听力分析

 目的探讨慢性化脓性中耳炎对骨导听力的影响。方法回顾性分析122例单侧慢性化脓性中耳炎患者,同期选取对侧正常耳作为对照耳,通过对患耳与健耳、不同年龄组、单纯型与胆脂瘤型中耳炎、听骨链完好与听骨链破坏、细菌培养阳性者与阴性者,不同病理患者的术前骨导听力进行研究。所有患者进行纯音测听检查, 并对各频率骨导听阈进行统计学处理, 对影响骨导听力的因素做相关分析。结果0.5、2、4 kHz处,患耳骨导听阈值高于健耳,而低频0.25 kHz及1 kHz处患耳与健耳骨导听阈值差异不显著;随年龄增长,患耳与健耳骨导听阈值差异有逐渐缩小趋势;中耳胆脂瘤及听骨链破坏者对各频率骨导有明显影响;病程及细菌培养阳性与否对骨导听力损害差异不显著。结论①慢性化脓性中耳炎对骨导听力有明显影响,但在不同频率,损害程度有差异;②慢性化脓性中耳炎可能会影响对侧正常耳的骨导听力;③中耳胆脂瘤及听骨链破坏对骨导听力影响较大。     

老年慢性化脓性中耳炎患者听力学分析

目的 探讨老年慢性化脓性中耳炎患者的听力学特点。方法 回顾性分析68例≥60岁单侧慢性化脓性中耳炎患者的语频（0.5、1.0、2.0、4.0kHz）纯音测听结果、术中所见中耳病变组织特点和听骨链病变情况、病变组织病理检查结果。结果 语频范围内,患耳气导、除4kHz外的骨导阈值均高于对侧耳;胆脂瘤患者与非胆脂瘤患者的气、骨导阈无明显差异;听骨链完好者与破坏者（中断或固定）的气导、2kHz骨导阈值差异具有统计学意义,0.5、1.0、4.0kHz骨导阈值差异不显著。结论 老年慢性化脓性中耳炎患者的听力改变有其独特性,掌握老年慢性化脓性中耳炎患者的听力学特征有助于疾病的诊治。     

中青年与老年慢性化脓性中耳炎及中耳胆脂瘤患者听力学特点及区别

目的 探讨中青年与老年慢性化脓性中耳炎及中耳胆脂瘤患者听力学特点及区别。方法 回顾性研究单侧慢性化脓性中耳炎或中耳胆脂瘤中青年(18～59岁)患者74例、老年(≥60岁)患者68例(语频段0.5、1.0、2.0、4.0 kHz)纯音测听结果, 分析其患耳与对侧耳、不同年龄组间患者听力学特征和区别。结果 中青年患者患耳各语频气、骨导阈值均高于对侧耳, 老年患者患耳气导、除4.0 kHz外的骨导高于对侧耳。老年患者各语频气、骨导耳间差均明显大于中青年患者。非胆脂瘤组、听骨链正常组老年患者耳间差在0.5、1.0、2.0 kHz气导、4.0 kHz骨导高于中青年患者。胆脂瘤组、听骨链中断组老年患者各语频气、骨导耳间差均明显大于中青年患者。结论 慢性化脓性中耳炎及中耳胆脂瘤对中青年、老年患者的气、骨导均可产生损害, 对老年患者的损害比中青年患者严重。中耳病变越严重, 老年患者比中青年患者听力受损的程度越高。     

慢性化脓性中耳炎对老年患者骨导听阈的影响

目的 探讨慢性化脓性中耳炎对老年患者骨导听阈的影响.方法 回顾性分析2005年1月至2009年3月在北京同仁医院耳鼻咽喉头颈外科住院治疗且资料完整的60岁以上单侧慢性化脓性中耳炎患者76例,分别记录患侧耳与对侧耳0.5、1、2、4 kHz四个频率的骨导阈值,以及每例患者中耳炎发病持续时间、听骨链是否中断、是否存在胆脂瘤等情况,并对记录的数据进行统计学分析.结果 患耳0.5、1、2、4 kHz四个频率的骨导阈值均高于对侧耳,差异有统计学意义(P值均＜0.01);胆脂瘤组与非胆脂瘤组相比,仅2 kHz双耳骨导阈值差的差异具有统计学意义(Z=-1.975,P=0.048);听骨链中断组与非中断组双耳骨导阙值差的差异也仅在2 kHz具有统计学意义(Z=-2.721,P=0.007);中耳炎病程10年以下组与10年以上组在1 kHz和2 kHz这两个频率的双耳骨导阈值差的差异具有统计学意义(Z值分别为-2.877和-2.624,P值均＜0.01).结论 慢性化脓性中耳炎可以使老年患者骨导阈值提高,对于老年慢性化脓性中耳炎仍应尽早积极治疗,避免感音神经性听力损失.     

慢性化脓性中耳炎的听骨链病变及对听力的影响

目的:探讨慢性化脓性中耳炎的听骨病变特点、听骨链完整性的判断及对骨导听力的影响.方法:对148例(176耳)慢性化脓性中耳炎患者行术前纯音测听,术中显微镜下观察听骨链病变.结果:骨疡型、胆脂瘤型中耳炎和鼓膜松弛部穿孔者听骨链多有破坏,松弛部穿孔先破坏锤砧关节,紧张部穿孔先破坏砧镫关节.慢性化脓性中耳炎听骨链完整、活动好52耳,听骨链中断或固定124耳.听骨链完好与听骨链病变者语频段气导听阈、气骨导差比较均差异有统计学意义(均P＜0.01).语频段骨导听阈比较无差异,两者高频骨导听阈均提高.结论:骨疡型、胆脂瘤型中耳炎听骨链多有破坏.语频段气导听阈在40 dB以内,气骨导差在30 dB以内者,听骨链大多完好.气导听阈在55 dB以上,气骨导差在40 dB以上者,听骨链多有中断或固定.慢性化脓性中耳炎可伴有高频骨导听力下降.     

感音神经性聋与分泌性中耳炎的相关性研究

目的：探讨感音神经性聋与分泌性中耳炎的关系。方法：对治疗后骨导听力下降仍未恢复的38例分泌性中耳炎患者进行分析，观察健耳和患耳在不同频率的骨导听阈情况，并分别就其发病年龄、病程、积液性质和积液量与骨导听阈的关系进行观察。结果：患耳在不同频率的骨导听阈均大于健耳（均P＜0．01）；年龄愈大、病程愈长，感音神经性聋发生率愈高；积液为黏液者发生率高于浆液者；但与积液量无明显关系。结论：分泌性中耳炎可导致感音神经性聋，其发病原因和机制是多方面的，年龄大、病程长、积液为黏液者更易导致感音神经性聋的发生；应提高认识，早诊断，早治疗。     

24耳胆脂瘤型中耳炎的听力损害

２４耳胆脂瘤型中耳炎的听力损害杨德生，康峰，吉云薇，弓玉鸾本文通过对２４耳胆脂瘤型中耳炎与２０耳单纯慢性化脓性中耳炎的纯音听阈比较发现：慢性化脓性中耳炎引起感音神经性聋以胆脂瘤型为多见，占本组８３．３％，而单纯性中耳炎者仅３０％。１临床资料经手术证实...     

慢性中耳炎与感音神经性聋

为了评估慢性中耳炎(COM)与感音神经性聋(SNHL)的关系,回顾分析了1986～1996年间行乳突手术的COM41例,年龄6～75岁(平均33.66岁)。病例标准:单侧COM(对侧耳鼓膜正常),无头部外伤史、脑膜炎史、耳手术史及全身耳毒性药物应用史。术前进行纯音测听,以对侧正常耳作为对照。患耳与对照耳骨导听阈之间的差值进行配对t检验(选用0.5、1、2、4kHz),并对COM持续时间、胆脂瘤的存在与否及听骨链的破坏情况与SNHL的程度之间的关系进行非参数统计学分析。研究表明:患耳与对照耳术前骨导听阈有显著性差异(P<0.01),范围为5.24～9.02dB。COM并发…     

慢性化脓性中耳炎致感音神经性聋相关因素分析

慢性化脓性中耳炎致感音神经性聋,其发病机制争议较多。笔者对64例（82耳）慢性化脓性中耳炎患者的骨导听阈进行分析,以探讨慢性化脓性中耳炎患者骨导听阈改变的相关因素。     

Sensorineural hearing loss in chronic otitis media.

Although many studies have demonstrated an association between chronic otitis media (COM) and sensorineural hearing loss (SNHL), there still remains disagreement about the relationship. A retrospective study was conducted to examine the relationship between sensorineural hearing loss and chronic otitis media. Forty-one patients met the following criteria: unilateral COM and no history of head injury, meningitis or previous otological surgery. The differences in preoperative bone conduction threshold between diseased and control (contralateral normal) ear were statistically significant (P < 0.01) and varied from 5.24 to 9.02 dB across the frequency range. The effect of duration of disease on the degree of SNHL was also analysed but no correlation was found. The presence of cholesteatoma and/or ossicular erosion was not associated with a significantly increased risk of sensorineural hearing loss.     

Predisposing factors for inner ear hearing loss association with chronic otitis media

The aim of the present study was to investigate the consequences of chronic otitis media on inner ear function. Retrospective analysis of conventional pure-tone audiometry tests was carried out on 344 patients who were scheduled for surgical treatment of unilateral chronic otitis media without other risk factors for sensorineural hearing loss. Bone conduction thresholds of diseased ears were compared with those of contralateral, non-diseased ears. Selected clinical features were assessed among diseased ears to examine possible influences on inner ear function. Mean bone conduction threshold differences varied from 0.6 dB at 0.5 kHz to 3.7 dB at 4 kHz. These differences augmented with increasing duration of middle ear disease. Impaired hearing by bone conduction thresholds of diseased ears correlated with increased age at every frequency and with an interruption of the ossicular chain only at higher frequencies. The severity of sensorineural hearing loss correlated with longer duration of middle ear disease. Thus, surgical treatment of dry and apparently stable tympanic membrane perforation is warranted.     

Predisposing factors for inner ear hearing loss association with chronic otitis media

The aim of the present study was to investigate the consequences of chronic otitis media on inner ear function. Retrospective analysis of conventional pure-tone audiometry tests was carried out on 344 patients who were scheduled for surgical treatment of unilateral chronic otitis media without other risk factors for sensorineural hearing loss. Bone conduction thresholds of diseased ears were compared with those of contralateral, non-diseased ears. Selected clinical features were assessed among diseased ears to examine possible influences on inner ear function. Mean bone conduction threshold differences varied from 0.6?dB at 0.5?kHz to 3.7?dB at 4?kHz. These differences augmented with increasing duration of middle ear disease. Impaired hearing by bone conduction thresholds of diseased ears correlated with increased age at every frequency and with an interruption of the ossicular chain only at higher frequencies. The severity of sensorineural hearing loss correlated with longer duration of middle ear disease. Thus, surgical treatment of dry and apparently stable tympanic membrane perforation is warranted.     

Sensorineural hearing loss in chronic otitis media

Although many studies have demonstrated an association between chronic otitis media (COM) and sensorineural hearing loss (SNHL), there still remains disagreement about the relationship. A retrospective study was conducted to examine the relationship between sensorineural hearing loss and chronic otitis media. Forty-one patients met the following criteria: unilateral COM and no history of head injury, meningitis or previous otological surgery. The differences in preoperative bone conduction threshold between diseased and control (contralateral normal) ear were statistically significant (P < 0.01) and varied from 5.24 to 9.02 dB across the frequency range. The effect of duration of disease on the degree of SNHL was also analysed but no correlation was found. The presence of cholesteatoma and/or ossicular erosion was not associated with a significantly increased risk of sensorineural hearing loss.     

Sensorineural hearing loss in patients with chronic otitis media

Chronic otitis media is generally associated with some degree of hearing loss, which is often the patient’s chief complaint. This hearing loss is usually conductive, resulting from tympanic membrane rupture and/or changes in the ossicular chain due to fixation or erosion caused by the chronic inflammatory process. When cholesteatoma or granulation tissue is present in the middle ear cleft, the degree of ossicular destruction is even greater. An issue that has recently gained attention is additional sensorineural hearing loss due to chronic otitis media. While the conductive loss can be minimized through surgery, sensorineural hearing loss constitutes a permanent after effect, attenuated only through the use of a hearing aid. However, a few groups have reported a decrease in sensorineural function in these patients as well. This survey study performed at a referral center evaluates the occurrence of sensorineural hearing loss in ambulatory patients with this disease. We reviewed the files of patients with unilateral chronic otitis media. One hundred and fifty patients met the inclusion criteria: normal otoscopy and normal hearing in the contralateral ear. Main outcome measure: bone-conduction threshold averages were calculated for frequencies of 500, 1,000, 2,000, 3,000 and 4,000 Hz, with comparison between the normal ear and the ear with chronic otitis media. Thresholds were examined separately for each frequency. The bone-conduction threshold averages for the normal side were lower than those for the ear with chronic otitis media. The threshold shift was statistically significant for each frequency (P < 0.0001, Student’s t test). There were differences between the groups when analyzed for age (500 and 1,000 Hz) or the presence of cholesteatoma (1,000 Hz). This study shows that chronic otitis media is associated with a decrease in cochlear function.     

Analysis of preoperative findings and ossicular condition in chronic suppurative otitis media]

OBJECTIVE: To discussion the relationship of preoperative findings and ossicular condition in chronic suppurative otitis media. METHOD: The correlation between the ossicular conditions and classification of tympanic membrane perforation, ear discharge, air conduction pure tone average, air-bone gap, pneumatization, complication, and cholesteatoma in 251 patients(288 ears) with chronic suppurative otitis media was analysed. RESULT: The air-conduction threshold and air-bone gap in patients with ossicular discontinuity are higher than that in patients with ossicular continuity. Ossicular discontinuity in patients with perforation of the pars flaccida of tympanic membrane, persistently draining ears, complications, and cholesteatoma occurred significiantly more frequently than those without these conditions. CONCLUSION: The air-conduction threshold and air-bone gap are the more reliable indications to identify the ossicular conditions in patients with chronic suppurative otitis media. There are significiant correlation between the ossicular conditions in patients with chronic otitis media and their classification of tympanic membrane perforation, ear discharge, complication, and cholesteatoma.