鼓室成形术后听力的临床观察

Observation of hearing improvement by tympanoplasty

目的观察鼓室成形术后听力恢复情况。方法总结2009年1月～2010年5月我科经治的103例慢性中耳炎患者资料,术后随访1年,听骨链完整患者31例,置入自体骨者22例,PORP 20例;羟基磷灰石全听骨赝复物14例,TORP者16例;比较各组患者术前、术后气骨差异,分析不同材料对患者术后听力恢复情况有无差别。结果不同类型鼓室成形术后与术前气骨导差比较差异均有统计学意义(P<0.05),其中置入自体骨与PORP的患者术后气导提高值为(22.52±6.50)dB、(22.56±5.87)dB,骨导提高值为(6.41±4.92)dB和(3.65±3.63)dB,置入羟基磷灰石听骨假体与TORP组术后气导提高值为(22.41±8.60)dB、(22.89±6.22)dB,骨导提高值为(2.77±3.87)dB和(4.81±6.83)dB,不同材料的听骨假体相比较,差异无统计学意义(P>0.05)。结论手术治疗慢性化脓性中耳炎对于改善听力效果明显,不同材料的听骨假体术后听力恢复情况无明显差异。

Objective To investigate the effect of tympanoplasty in patients with middle ear disorders. Methods The study focused on 103 patients （from January 2009 to May 2010） with post-operative therapy was 12 months, including 31 patients with intact ossicular chain, 22 patients with autogenously bone graft, 20 patients with PORP, 14 patients with hydroxyap- atite graft, 16 patients with TORP. The following parameters were evaluated： air-bone gap pre and post-operative, hearing results using different materials. Results Compared with pre-operative, post-operative air-bone gap changed statistically. The air-conduction hearing resulting for autogenously bone graft and PORP improved 22.52±6.50, 22.56±5.87 dB; Bone- conduction increased 6.41±4.92, 3.65±3.63 dB; Air-conduction for hydroxyapatite graft and TORP improved 22.41±8.60, 22.89±6.22 dB; Bone-conduction increased 2.77±3.87, 4.81±6.83 dB. It showed there was no significance difference among different material prosthesis （P 〉 0.05）. Conclusion This research suggests that tympanoplasty is useful, but we couldn＇t find differences between graft materials for hearing restoration.