先天性卵圆窗闭锁患者的听力检测结果分析

Audiological Characteristics in Patients with Congenital Atresia of the Oval Window

目的分析先天性卵圆窗闭锁患者的临床听力学特点。方法回顾性分析63例(77耳)经手术证实为先天性卵圆窗闭锁患者的临床症状及纯音听阈、声导抗检测特征。结果患者均表现为自幼听力差,多为单侧,伴耳鸣9例,无耳鸣54例,纯音测听显示为不同程度传导性听力损失(50耳,64.94%),或以传导性听力损失为主的混合性听力损失(27耳,35.06%),低频率段(0.125～1kHz)平均气导听阈为72.07±11.10dB HL,明显高于高频率段(2～8kHz)平均气导听阈(58.73±14.95dB HL)(P<0.01);低频率段(0.25～1kHz)平均骨导听阈为11.97±10.69dB HL,明显低于高频率段(2～4kHz)骨导听阈(19.03±13.55dB HL)(P<0.01),2kHz处骨导下降最为明显;低频率段平均气骨导差值(61.08±12.67dB)明显大于高频率段(39.51±11.38dB)(P<0.01);鼓室导抗图A型60耳,As型5耳,Ad型4耳,B型2耳,C型6耳;69耳鼓室压力均在正常范围,鼓室导抗图为C型的6耳鼓室压力在-110～-235daPa之间;77耳患侧和对侧镫骨肌声反射均消失。结论先天性卵圆窗闭锁患者主要表现为传导性听力损失,或以传导性听力损失为主的混合性听力损失;低频段气导听力损失大于高频段。

Objective To analyze the clinical audiological characteristics in patients with congenital atresia of the oval window.Methods The audiological data of 63cases（77ears） with congenital atresia of the oval window,confirmed by operative finding were reviewed retrospectively.Results The findings showed that various degrees of conductive hearing losses（50ears）,accompanied with mixed hearing losses（27ears） were found in this group.The average threshold of air conduction in low frequencies（0.125～1kHz） was above 70dB HL,much greater than that（P0.01） of high frequencies（2～8kHz）.The average threshold of bone conduction at low frequencies（0.25～1 kHz） was much lower than that（P0.01） of high frequencies（2～4kHz）.An obvious notch was found at 2kHz.The average gap between air-bone conduction at low frequencies（0.25～1kHz） was much greater than that at high frequencies（2～4kHz）.Of all the patients（77ears） who received tympanometry,60ears were detected with type A tympanogram,5with type As tympanogram,4with type Ad tympanogram,with normal tympanic pressure.2ears with type B tympanogram,6with type C tympanogram,with the pressure between-110～-235daPa.The lateral and contralateral acoustic stapedius reflex was absent in all patients.Conclusion The anomalies of the oval window should be sought in all patients with congenital hearing loss.It is important to have a better understanding of the clinical audiological characteristics in patients with congenital atresia of the oval window is important in both diagnosis and surgical planning.