慢性化脓性中耳炎鼓室成形术后骨导听力的改变

目的探讨鼓室成形术对慢性化脓性中耳炎患者骨导听力影响。方法回顾分析伴有骨导听阈下降的慢性化脓性中耳炎患者80例的临床资料。结果术后骨导听力改善50耳（54．35％）。各频率骨导听阈值均显著下降，骨导听力提高（P〈0．01）；病程长短与是否伴胆脂瘤对术后骨导听力无显著影响（P〉0．05），术中听骨链重建者骨导听力显著改善（P〈0．05），不伴乳突切开的鼓室成形术（A）与保留外耳道后壁的乳突切开鼓室成形术（B）后骨导听力改善均较不保留耳道后壁的乳突切开鼓室成形术（C）显著（P〈O．05），h与B之间无显著差异（P〉0．05）。结论鼓室成形术治疗伴骨导听力下降慢性化脓性中耳炎术后部分患者骨导听力获提高，骨导听力改善与病程长短及是否伴胆脂瘤无关，与手术方式相关。

Analysis of Bone Conduction Hearing in Chronic Suppurative Otitis Media after Tympanoplasty

Objective To investigate the effect of bone conduction hearing （ BCH ） variations in chronic suppurative otitis media （ CSOM ） after tympaneplasty. Methods Retrospective analyze the clinical data of 80 cases （ 92 ears ） of CSOM accompanied by decreasing BCH. Results The BCH of 50 ears （ 54.35% ） had improved. The BCH of each frequency was increased （ P 〈 0.01 ）. Course of disease or whether accompanied by cholesteatoma was not related to the BCH improved （ P 〉0.05 ）. The BCH of the patient after ossicalar replacement prosthesis had observably improved （P 〈 0.05 ）.The BCH after tympanoplasty without mastoidectomy （ A ） and canal wall up mastoidectomy with tympanoplasty （ B ） were observably improved than canal wall down mastoidectomy with tympanoplasty （ C ） （ P 〈 0.05 ）, the BCH between A and B had not significant difference （ P 〉 0.05 ）. Conclusion Tympanoplasty could improve the BCH of the patient of CSOM accompanied by decreasing BCH. The improved of BCH was related to kind of surgery , but not related to courses of disease or whether accompanied by cholesteatoma.