中耳手术中电钻噪声对耳蜗功能的影响

Influence of Drilling Noise on the Cochlear Function after Middle Ear Surgeries

目的探讨中耳手术中电钻噪声对耳蜗功能的影响。方法对32例单侧慢性化脓性中耳炎患者行乳突根治及鼓室成形术,术中采用TES-1351声级计检测使用不同规格电钻钻头对手术产生的噪声,比较手术耳及非手术耳手术前、术后2周及3个月时1、2、4、6、8kHz各频率的平均骨导听阈。结果术中不同规格电钻钻头发出的噪声强度为93～112dB SPL,手术耳术后2周1、2、4、6、8kHz骨导平均听阈较术前升高(P<0.05),而在术后3个月时1、2kHz平均骨导听阈与术前差异无统计学意义(P>0.05),但4、6、8kHz平均骨导听阈仍高于术前水平(P<0.05)。非手术耳术后2周及3个月时1、2kHz骨导平均听阈与术前相比有所提高,但其差异无统计学意义(P>0.05);而4、6和8kHz骨导平均听阈仍较术前升高(P<0.05)。结论中耳手术中电钻噪声对耳蜗功能有一定损伤,以高频区明显。

Objective To investigate the effects of noises generated by drilling on the cochlear function of op- erated ear during middle ear surgeries. Methods A TES-1351 Sound Level Meter was used to measure noise levels from drills with different specifications of bits during the middle ear surgeries. Bone-conduction hearing thresholds of the operated ear and non-operated ear were measured before and two weeks and three months after operation. Results Noise levels generated by different drills used in operations ranged from 93 to 112 dB SPL. The bone- conduction hearing thresholds at 1,2,4,6,8 kHz of the operated ear at two weeks after operation were significantly elevated than those of before operation（P〈0.05） and only the differences at 1,2 kHz became no significant at three months after operation（P〈0.05）. The hone-conduction hearing thresholds of the non-operated ear at 1,2 kHz increased at two weeks and three months after operation in the two frequencies, but the differences were not signifi- cant（P〉0.05）. While at the frequencies of 4, 6 and 8 kHz, bone conduction hearing thresholds of both the opera- ted ear and non-operated ear were significantly elevated after operation（P〈0.05）. Conclusion Drilling noises dur- ing middle ear surgeries can cause functional damage to the cochlea.