儿童分泌性中耳炎致骨导听力下降的临床特征分析

Mixed hearing loss associated with otitis media with effusion in children

目的探讨儿童分泌性中耳炎致骨导听力下降的特点、病因和预后。方法回顾性分析75例(82耳)分泌性中耳炎患儿骨导听力下降的临床资料,并对其发病年龄、病程、积液性质和积液量与骨导听阈的关系进行观察。结果 75例患儿(82耳)骨导听力下降,平均骨导阈值在2.0kHz和4.0kHz处增高最明显。骨导听阈与病程和积液性质显著相关(P<0.01或P<0.05),与年龄、积液量无关。75例患儿均采取鼓膜切开置管术和(或)腺样体切除术,术后给予药物治疗。随访6月,听力恢复正常者76耳,气导听阈下降但骨导听阈无改善者6耳。结论分泌性中耳炎可导致儿童骨导阈值增高,是导致儿童耳聋的危险因素之一,及早干预可避免病情发展。

Objective To investigate the characteristics, cause and prognosis of bone conduction hearing loss associated with otitis media with effusion （OME） in children. Methods Seventy five cases（82 ears） of bone conduction hearing loss associated with otitis media with effusion in children were reviewed. The correlation between bone conduction hearing thresholds and age, disease duration, nature of middle ear fluid and effusion amount were studied. Results In the 75 cases, bone conduction hearing threshold increases was most obvious at 2 and 4 kHz, and was correlated with disease duration and nature of middle ear fluid （P〈0.01 and P 〈0. 05 respectively）, but not with age and effusion amount. All patients were treated with myringotomy with insertion of ventilation tubes and/or adenoids removal. All cases received pharmacological treatment after the operation. Bone conduction hearing thresholds returned to normal in 76 ears and improved slightly in 6 ears during the six months follow-up. Conclusion OME in children can lead to bone conduction threshold shift. OME is a major risk factor of hearing loss in children and health care providers need to be aware of possible development of OME