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。     

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。     

慢性化脓性中耳炎与感音神经性聋的相关性分析

目的：探讨慢性化脓性中耳炎与感音神经性聋之间的相关性。方法：回顾分析174例单侧慢性化脓性中耳炎患者的骨导阈值改变。采用配对t检验分析0．5kHz，1．0kHz，2．0kHz，4．0kHz患耳与健耳骨导阈值的差异，单因素方差分析法分析胆脂瘤存在及听骨链破坏对语频(0．5kHz，1．0kHz，2．0kHz)和4．0kHz骨导阈值的影响，直线回归法讨论了语频和4．0kHz骨导阈值改变与年龄和病程之间的相关性。结果：患耳与健耳各频率骨导阈值之间差异有统计学意义。语频骨导听力损失程度随着患者年龄的增加而逐渐加重。胆脂瘤的存在以及听骨链破坏亦未增加感音神经性聋的发生概率。结论：慢性化脓性中耳炎可引起感音神经性聋。高频骨导听阈较低频更易受到影响。     

慢性化脓性中耳炎患者鼓室成形术后骨导听力的改变

目的探讨合并骨导听力下降的慢性化脓性中耳炎患者鼓室成形术后骨导听力的变化及其相关因素。方法回顾性分析54例（61耳）合并骨导听力下降的慢性化脓性中耳炎行鼓室成形术患者的临床资料,分析患者术前、术后0．5、1、2、4kHz骨导听力的变化及其与病程、是否合并胆脂瘤、术式、是否行听骨链重建的关系。结果61耳术前骨导平均听力在4kHz处损害最为严重,术后4个频率听力均有不同程度的提高,提高幅度以2kHz处最为显著,术后骨导改善阳性（4个频率无一频率骨导听力下降,且有至少二个频率的骨导听力提高10dB以上）有32耳,阳性率为52．5%。病程长短及是否伴有胆脂瘤与术后骨导听力改善与否无明显相关。行听骨链重建的病例骨导听力提高明显优于未行听骨链重建病例。未行乳突切开的鼓室成形术和保留外耳道后壁的乳突切开鼓室成形术患者术后骨导改善较切除外耳道后壁的乳突切开鼓室成形术患者明显。结论伴骨导听力下降的慢性化脓性中耳炎经鼓室成形术后部分患者骨导听力可以提高,其术后听力改善程度与病程长短及是否伴有胆脂瘤无关,与手术方式有关。     

儿童与成人慢性化脓性中耳炎听力学分析

目的　探讨儿童组与成人组不同类型慢性化脓性中耳炎 (CSOM)听力损失有何异同。方法　对 70例(85耳 )儿童和 99例 (14 1耳 )成人进行纯音测听检查 ,两组患耳进行比较。结果　两组三个类型CSOM患者纯音测听气导听阈均升高。单纯型CSOM在 1～ 8kHz范围内 ,两组气导检查结果呈现听力损失一致 (P >0 .0 5 )。骨疡型和胆脂瘤型CSOM ,除骨疡型 8kHz外 ,两组患耳各频率听力损失也相同 (P >0 .0 5 )。儿童组单纯型CSOM骨导检查结果基本正常 ,而骨疡型和胆脂瘤型CSOM ,成人组在中高频听力损失比儿童重。结论　虽然儿童CSOM病程短 ,呈现气导检查中频、高频听力损失与成人一样重的趋势 ,但无内耳损害或损害较轻。     

分泌性中耳炎骨导听阈改变的临床观察

目的证实分泌性中耳炎可导致感音神经性聋,为临床干预分泌性中耳炎,尤其是顽固的分泌性中耳炎提供依据.方法115例(164耳)分泌性中耳炎患者治愈后或未愈患者病程中复查的纯音测听检查结果,记录0.5、1、2、4kHz频率骨导听阈,计算骨导听力损失dB数.分为单侧组66例,双侧组49例,将66例单耳患者的健耳作为对照组.结果在164耳中,出现骨导听阈提高的共94耳(57.3%).双侧组与单侧组骨导听力损失程度差异均无显著性(P>0.05);单侧组和双侧组患耳在同一频率的骨导听力损失程度相似,且平均的骨导听力损失程度也相似;不同频率之间的骨导听力损失不同,4kHz的骨导听力损失为最大.结论半数以上分泌性中耳炎可以导致感音神经性聋.在不同频率间的骨导听力损失不同,以高频损失为主,并有向语言频率区过渡的趋势.     

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。     

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。     

胆脂瘤型中耳炎听力损害的临床分析

目的 探讨胆脂瘤型中耳炎的听力特点,为临床干预胆脂瘤型中耳炎提供依据.方法 回顾性分析156耳胆脂瘤型中耳炎患者术前纯音听闻临床资料,结合听骨链破坏情况作统计学分析.结果病例中男性84耳,女性72耳,平均年龄32.98岁(6～78岁),听力损害在不同性别、年龄、民族、病程中差异无显著性(P＞0.05);不同频率之间的骨导听阈差异有统计学意义(P＜0.01);听骨链破坏在不同性别、年龄、民族中差异无显著性(P＞0.05),听骨链破坏程度在不同病程中差异有显著性(P＜0.01).结论 在胆脂瘤型中耳炎病例中,不同频率间的骨导听力损失不同,以高频听力损失为主;病程越长,听骨链破坏越严重.     

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.     

慢性化脓性中耳炎鼓室成形术前后骨导听阈变化的临床观察

目的:探讨慢性化脓性中耳炎术前骨导听阈提高与术后骨导听阈变化的相关因素.方法:单侧慢性化脓性中耳炎行鼓室成形术45例,术前3 d内和术后3个月分别行常规纯音测听,术前患侧与健侧相比,骨导听阈0.25～8.00 kHz至少连续2个或2个以上频率增加≥10 dB为术前骨导听阈提高阳性;术后3个月与术前相比,0.25～8.00 kHz至少2个或2个以上频率减少≥10 dB为术后骨导听阈下降阳性,增加≥10 dB为术后骨导听阈提高阳性.结果:45例中35例(77.8%)术前骨导听阈提高阳性,与病程长短、是否伴有胆脂瘤无关,但与听骨链破坏有相关性(P＜0.05),听骨链中断易导致术前骨导听阈提高;术前骨导听阈提高阳性35例中有6例(17.1%)术后骨导听阈下降阳性;45例患者中有5例(11.1%)术后骨导听阈提高阳性.结论:慢性化脓性中耳炎可造成骨导听阈提高,鼓室成形术不仅可使气导听阈下降、缩小气骨导差,还可使骨导听阈下降;术中过多触动听骨链及噪声等可造成术后骨导听阈提高.     

Intractable otitis media with eosinophils: Importance of diagnosis and validity of treatment for hearing preservation

This study investigated hearing levels in cases of intractable otitis media with eosinophils and validated the treatment strategy. Medical charts were reviewed retrospectively. The diagnosis was made when the proportion of eosinophils in middle ear secretions exceeded 10%. Twelve patients were identified and treated with an antihistaminergic agent, leukotriene receptor antagonist and topical steroid. The air-bone conductance gap decreased significantly with the relief of subjective symptoms. Bone conduction hearing levels at 4 and 8 kHz were higher than at lower frequencies. There was a significant correlation between subjective symptom duration and bone conduction hearing level at 8 kHz, which diminished with treatment. Compared with suppurative otitis, active otitis with eosinophilia damages high-tone sensory hearing in a time-dependent manner, and antiallergic treatment prevents progression of the high-tone sensory hearing loss. We emphasize the importance of diagnosis and the validity of treatment for intractable otitis media with eosinophils.     

Audiometric findings in children with chronic suppurative otitis media without cholesteatoma

Chronic suppurative otitis media without cholesteatoma (CSOMWC) is usually associated with an increase in air conduction thresholds. However, only a few investigations reported on loss of cochlear function in the pediatric population. We undertook a prospective study in order to further delineate air and bone conduction levels in children with CSOMWC and the possible relationship between sensorineural hearing loss (SNHL) and other clinical characteristics that might reflect the extent of disease. Eighty-seven children were enrolled, 40 of which had bilateral disease. Hence, the total number of diseased ears tested was 127. Audiometric studies were performed three days after achieving a ‘dry’ ear following medical treatment. We found no statistically significant differences between the bone conduction threshold tested in ears with CSOMWC and control ears. This was also the case in 47 children with unilateral disease when cochlear function was investigated in the diseased and uninvolved ear in the same patient. Clinical correlation showed no association between age, sex, duration of otorrhea and presence of granulation or polyps and the degree of cochlear loss. Our study shows that CSOMWC in children has little effect on cochlear function.     

Audiovestibular profile in unilateral chronic suppurative otitis media

AudioIogical tests including middle ear impedance test and vestibular function tests were administered to seventyfive patients of unilateral chronic suppurative otitis media. These patients were selected so as to exclude the influence of hereditory, drugs, systemic illness and the factors of aging. The subjects were subdivided into 3 groups : group 1 cases with central perforation; group 2 with marginal and group 3 with attic perforation respectively. On pure tone audiometry, 19 diseased ears (25.3%) showed sensorineural hearing loss of 40 dB or more at 4 KHz and 8 KHz. The difference in the mean bone conduction threshold of diseased and the nondiseased ears was statistically significant at 4 KHz and above. Results of specialised tests of hearing suggested cochlear pathology being responsible for sensorneural hearing loss. Electronystagmographic recording of saccades and bithermal caloric induced nystagmus revealed canal paresis on the diseased side in 4 patients (5.3%). These 4 patients had 15 years history of otorrhoea.