两种手术方式对慢性中耳炎听力改善的临床分析

The Clinical Analysis of the Media Listening Improvement of Two Kinds of Operation Method for Chronic Otitis

目的:研究慢性中耳炎患者术后听力改善及其可能相关影响因素。方法:随访自2010年3月至2012年5月于本院耳鼻喉科进行慢性中耳炎手术的患者,将随访资料的病例行回顾性分析。结果:84例置入PORP病例术后气导听阈平均39.6±14.9dB,较术前,提高平均为13.9±13.2dB(P<0.001);平均气骨导差为20.5±8.5dB,气骨导差改变平均为8.8±10.7dB(P<0.001)。术后气导听阈改善在0.5 KHz,1KHz,2KHz三个频率上无明显差异(P>0.05),而气骨导差改善显示2KHz的改善不及0.5KHz,l KHz的气骨导差改善((P<0.001)。6例行颞肌筋膜鼓膜成型术病例术后气导听阈平均21.1±4.3dB,较之术前提高平均为13.6±7.2dB(P<0.05),平均气骨导差为11.1±4.2dB,气骨导差改变平均为6.7±4.2dB(P<0.05)。结论:置入PORP、颞肌筋膜鼓膜成型术均可明显改善听力。慢性中耳炎手术治疗效果令人满意,羟基磷灰石假体听骨对于听力改善效果肯定。

Objective： To investigate the hearing improvement postoperatively in patients with chronic otitis media and its possible related factors. Methods： fromMarch2010toMay2012inourhospital otolaryngology,patientswithehronicotitismedia operation were fol- lowed up, the follow-up information line of cases were retrospectively analyzed. Results： 84 cases in PORP postoperative gas conduction audibility threshold average were 39.6± 14.9 dB, theaverageincrease was 13.9a±13.2dB compared withpreoperative （P〈0.001）. A mean of bones guide was 20.5± 20.5 dB, and poor bones conductivity was changed to an average of 8.8± 10.7 dB （P〈0.001 ）. Postoperative air conduction audibility threshold at frequency of 0.5 KHz, 1 KHz, 2 KHz were no obvious difference （P〉0.05）, and poor bones guide at 2 KHz was less than that at 0.5 KHz and 1 KHz （P〈0.001）. In 6 temporalis fascia routine tympanic membrane forming cases, average air conduction heating threshold was 21.1 ± 4.3 dB, and increased 13.6± 7.2 dB compared to the preoperative （P〈0.05）, the average of poor bones guide was 11.1± 4.2 riB, the average of poor bones conductivity change was 6.7±4.2 dB （P〈0.05）. Conclusion： Placing PORP, tempo- ralis fascia tympanic membrane forming technique can obviously improve the hearing. Surgical treatment of chronic otitis media effect is satisfactory, and hydroxyapatite prosthesis auditory ossicle has the improvement effect on hearing.