纯音听力测试对慢性化脓性中耳炎患者听骨链状态的评估价值

Predictive value of ossicular discontinuity in chronic suppurative otitis media using pure-tone audiometry

目的探讨术前纯音听力测试对慢性化脓性中耳炎患者听骨链连接状态的评估价值。方法回顾性分析56例行鼓室成形术的慢性化脓性中耳炎患者的术前纯音听力测试结果,并根据手术探查结果将其分为听骨链中断组与非中断组。使用SPSS 18.0统计软件对两组4个频率(0.5、1.0、2.0、4.0 kHz)的术前纯音听力测试各个气骨导差以及该4个频率的平均气骨导差进行统计分析。结果听骨链中断组与非中断组气骨导差平均值差异具有统计学意义(t=-4.043,P<0.05),2 kHz的气骨导差在听骨链中断组与非中断组之间具有统计学差异(t=-3.334,P<0.05),而0.5、1.0、4.0 kHz的气骨导差两组间差异无统计学意义。结论术前纯音听力测试2 kHz气骨导差对于慢性化脓性中耳炎患者听骨链中断与否有一定的评估价值。

OBJECTIVE To analyze the predictive value of preoperative air-bone gap（ABG）for ossicular discontinuity（OD）among chronic suppurative otitis media（CSOM）patients.METHODS Records of 56 patients with CSOM,who were 12 to 69 years old and underwent their first tympanoplasty,were reviewed.The pure tone audiometry was observed before operation.The presence or absence of OD was observed under microscope during operations.These patients were classified into two groups according to the presence or absence of OD.Frequency-specific ABG values and the mean ABG values of the 4 frequencies（0.5,1.0,2.0,4.0 kHz）were compared using T test between the two groups.RESULTS Compared with normal ossicular chain group,average ABG at speech frequencies（0.5,1.0,2.0,4.0 kHz）in OD group was higher,the difference was significant between the two groups（t=-4.043,P0.05）.But frequency-specific ABG was higher only at 2 kHz among the 4 frequencies（t=-3.334,P0.05）.CONCLUSION Preoperative ABG at 2 kHz frequence has predictive value for OD in CSOM.