高空迅速减压对中耳和听力的影响

The Effects of Rapid Altitude Decompression on the Middle Ear and Hearing

目的分析高空迅速减压对中耳和听力的影响。方法对因意外导致的某运-8飞机12名机组人员在7 000 m高空爆舱2天后行耳内镜检查和纯音测听、声导抗测试。结果发生飞机舱内迅速减压时,12人均曾有耳痛、耳鸣,均经做吞咽动作数秒钟后症状缓解,着陆后无听力下降感。耳内镜检查示2人双侧鼓膜Ⅱ度充血,10例鼓膜正常;纯音测听示1人右耳中高频区感音神经性听力损失(平均听阈35 dB HL),其余23耳气骨导听阈均≤25 dB HL;鼓室导抗图11人22耳A型,1人双耳Ad型,12人24耳耳声反射均正常。10人飞行合格,2名轻度耳气压伤者经对症处理1周后痊愈,恢复飞行。随访1年,12名机组人员均在继续飞行。结论本次高空迅速减压对中耳和听力损伤程度轻,与高空爆舱的不可控因素(飞行高度相对低和迅速减压速率相对慢)及可控因素(飞行员快速下降飞机飞行高度和机组人员采用咽鼓管主动开放动作等应对措施)密切相关。

Objective To analyze the effects of rapid altitude decompression on the middle ear and hearing of 12 pilots.Methods Pure tone audiometry,acoustic immittance test and otoscopy were carried out for the pilots after 2 days of the sudden loss of cabin pressure in the transporter-8 at 7 000 meters altitude.Results The hearing thresholds of 11 pilots were normal and the middle-high frequency sensorineural hearing loss（average threshold 35 dB HL） in the right ear of 1 pilot was noted.The acoustic stapedius reflexes of 12 pilots were normal,the tympanograms of 11 pilots（22 ears） showed type A and one pilot showed Ad in each ear.Only light congestion was observed in the eardrums of 2 pilots under otoscopy.10 pilots were granted for flying qualification.After one week proper treatment,all the pilots had recovered their health and returned to their flying duties.Conclusion Only light injury to the middle ear and hearing in this flying affair may be related to the uncontrollable fact（the relative low flying altitude and the relative slowly velocity of rapid altitude decompression） and the controllable fact（rapid flying decreasing and eustachian tube initiative opening）.