摘要
为探讨慢性化脓性中耳炎影响内耳听觉功能的机理。统计了２００例、２４０耳慢性化脓性中耳炎（ＣＯＭ）患者的病史、纯音测听、乳突拍片和ＣＴ扫描的结果；并对中耳病变与耳聋性质及程度的关系，进行分析。制备化脓性中耳炎豚鼠１２只、１５耳，在光镜及电镜下观察耳蜗Ｃｏｒｔｉ′ｓ器外毛细胞的病理变化。结果：本组患者合并感音性聋（ＳＮＨＬ）１０７耳，占４４．６％；病史５年以内及５年以上ＳＮＨＬ合并率分别为２８．５％和６３．６％，差异有高度显著性（Ｐ＜０．０１）；中耳病变Ⅰ型及Ⅱ～Ⅲ型ＣＯＭ患者ＳＮＨＬ合并率为２７．９％和８５．７％，差异有高度显著性（Ｐ＜０．０１）；观察ＣＯＭ豚鼠耳蜗Ｃｏｒｔｉ′ｓ器外毛细胞有病理损害。病史越长，中耳病变越重，耳蜗外毛细胞损害越重，ＳＮＨＬ合并率越高。
In order to approach the mechanism by which chronic suppurative
otitis media(COM) affects on hearing function of inner ear,240 ears from 200 patients with
COM,together with their medical histories were counted,and pure tone audiometry and mastiod
radiographs were performed.The relationships between medical history, the pathological
change, of middle ear and the quality and degree of deafness were analized.12 guinea pigs,15
ears,with COM were prepared to observe the pathological change in the Cortis organ and outer
hair cells through light and electric microscope.The results showed that 107 COM ears in this
group complicated with sensorineural deafness(SNHL),mading up 44.6%. On medical
history,those within 5 years complicated SNHL with 28.5%,and those over 5 years with
63.6%.Theres notable difference between them( P<0.01) .Patients with COM with type I middle
ears damage complicated SNHL by 27.9%,while those with type +,by 85.7%.By observing the
COM guinea p higher incidence of SNHL is.igs Cortis organ,the pathological damage in outer
hair cells was found.The longer the COM histroy is,the more serious the middle ears
pathological change is,the more serious the damage on coheals outer hair cells is,the
