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。

Audiologic features and differences ofchronic suppurativeotitis media or cholesteatoma of middleear in adults and elderly patients

Objective To explore the audiologic features and differences between the adult and elderly patients with chronic suppurative otitis media (CSOM) or cholesteatoma of middle ear(CME). Methods A retrospective study was carried out on pure tone tests (at speech frequencies 0.5, 1.0, 2.0 and 4.0 kHz)in 74 adult patients (18-59 years) and 68 elderly patients (over 60 years) with unilateral CSOM or CME.The audiologic features and differences were analyzed between the ill ears and healthy ears, as well as between the two age groups. Results In adult patients, the thresholds of air and bone conduction at all speech frequencies were significantly higher in ill ears compared with healthy ears. In elderly patients, the same results were observed between ill ears and healthy ears, except at 4.0 kHz of bone conduction. Compared with the adult patients, interaural thresholds of air and bone conduction at all speech frequencies were higher in elderly patients.In non-cholesteatoma and normal ossicular chain groups, interaural thresholds of air conduction at 0.5, 1.0, 2.0 kHz and bone conduction at 4.0 kHz were significantly higher in elderly patients compared with the adult patients.Furthermore, in both the cholesteatoma and abnormal ossicular chain groups, elderly patients showed significantly higher interaural thresholds of air and bone conduction at all speech frequencies as compared with the adult patients. Conclusion CSOM and CME can cause air conduction and bone conduction damage in both adult and elderly patients. In addition, the damage to elderly patients is worse than adult patients. At severe levels of middle ear disease, hearing loss is more severe in elderly patients versus adult patients.