颞骨骨折早期干预对听力的影响

目的 探讨早期干预措施对颞骨骨折患者听力的影响。方法 采用早期干预和常规疗法对我院1999年1月-2004年3月收治的32例颞骨骨折患者进行前瞻性随机对照临床研究。结果 伤后1个月干预组纯音听力气导平均阈值明显低于对照组（P〈0．05），但听性脑干反应（ABR）、40Hz听性相关电位和声反射平均阈值两组问差异无统计学意义（P〉0．05）；伤后6个月干预组纯音听力气导平均阈值、骨导平均阈值、声反射平均阈值、ABR、40Hz听性相关电位平均阈值明显低于对照组（P〈0．05）。结论 早期干预对颞骨骨折所致的传导性聋具有治疗作用，对感音性聋具有积极预防作用，但作用仅限于维持迷路系统及邻近重要结构的完整以及内耳内环境的稳定。整体干预效果好于传统疗法。

Effect of early intervention on hearing of cases with temporal bone fracture

Objective To evaluate the effect of the early intervention on hearing of patients with temporal bone fractures. Methods A random, control and prospective study was carried out in 32 cases with temporal bone fractures that were treated with early intervention and the routine treatment from January 1999 to March 2004 in our hospital. Results One month after fracture, the air-conductive threshold of pure tone in the intervention group was more significantly decreased than that in the control group (P<0.05), but there was no significant difference in both groups upon threshold of auditory brainstem response (ABR), 40 Hz auditory event related potential (AERP) and acoustic stapedius reflex (P>0.05). Six months after fracture, the air-conductive threshold of pure tone, the bone-conductive threshold of pure tone, the threshold of ABR, 40 Hz AERP and the acoustic stapedius reflex in the intervention group were more significantly decreased than that in the control group (P<0.05). ConclusionsEarly intervention is helpful for treatment of the conductive hearing loss and has positive preventive effect on sensorioneural deafness resulted from temporal bone fractures. Nonetheless, such intervention is only limited to maintain integrity and homeostasis of the labyrinth and the internal milieu of the inner ear and as a whole, exerts better effect than the routine treatment.