开放式鼓室成形听力重建术不同频率效果分析

目的探讨慢性中耳炎患者开放式鼓室成形术后听力重建效果,并对不同频率听力重建效果进行对比分析。方法回顾2008年6月至2011年1月在复旦大学附属眼耳鼻喉科医院耳鼻喉科行开放式鼓室成形术的920例患者,从中筛选具有完整随访资料患者87名,利用纯音测听对患者手术前后0.25kHz、0.5kHz、1kHz、2kHz、3kHz、4kHz、6kHz频率处的纯音气导听阈、骨导听阈和气骨导差进行评估,比较各项指标手术前后差异,探讨各频率重建效果的可能影响因素。结果术后气导听阈总体平均值在各个频率均有显著改善,听觉重建效果从低频到高频呈下降趋势,其中1kHz以下频率明显优于2kHz以上频率;术后气骨导差总体平均值在各个频率均有显著改善,且听觉重建效果从低频到高频呈下降趋势,其中1kHz以下明显优于2kHz以上;术后骨导听阈总体平均值除4kHz,其余各频率均有显著改善,1kHz重建效果显著优于其他频率,未做听骨链重建患者平均骨导听阈只有1kHz频率略有改善;术后随访期内无复发患者。结论开放式鼓室成形术在清除病灶同时可有效重建慢性中耳炎患者听觉能力,低中频显著。

Frequency-specific hearing assessment after canal wall-down tympanoplasty for chronic ear diseases

Objectives To analyze frequency-specific hearing results after canal wall-down tympanoplasty for chronic ear diseases, in relation to various surgical factors. Methods Patients who underwent canal wall-down tympanoplasty for chronic ear diseases from June 2008 to January 2011 in the Department of Otolaryngology, Eye Ear Nose & Throat Hospital, Fudan University were reviewed retrospectively (n=87). Using pure tone audiometry, air-conductive threshold (AC), bone-conductive threshold ( BC ), and air-bone gap (ABG), and pre-and post-operative changes were analyzed for each of the followingfrequencies: 0.25 kHz, 0.5 kHz, 1 kHz, 2 kHz, 3 kHz, 4 kHz (AC and BC) and 6 kHz (AC). Frequency-specific results were investigated in relation to various surgical factors. Results Both AC and ABG results showed improvements at each frequency, primarily in the low and mid frequencies. The improvement decreased gradually from low to high frequencies. BC results showed significant improvement at every frequency except 4 kHz. In patients without ossiculoplasty, BC results improved significantly only at 1 kHz. Conclusion Canal wall-down tympanoplasty for chronic ear diseases can improve hearing primarily in low and mid frequencies.