以听力突然下降为特征的分泌性中耳炎(附24例报告)

Secretory Otitis Media Characterized by Sudden Hearing Loss( Report of 24 cases)

目的 提高对以听力突然下降为特征的分泌性中耳炎的确诊率。方法 回顾性分析２４例（２８耳）以听力突然下降为特征的分泌性中耳炎的临床资料。结果 １１例患者被误诊或漏诊，各频率的平均气导阈值在６０．２～６６．５ ｄＢ ＨＬ，平均骨导阈值在４０．５～５８．６ ｄＢ ＨＬ，听力图示感音神经性聋９耳，混合性聋 １９耳，鼓室压图为 Ｂ型，治疗后听力明显改善。结论 鼓室积液影响圆窗及卵圆窗间的相位差，导致听力突然下降，它们的听力图无特征，并对产生误诊的原因进行了讨论。

Objective To increase the knowledge and the diagnostic level of secretory otitis media(SOM). Methods 24 cases(28 ears) of SOM characterized by sudden hearing loss were retrospectively analyzed. Results Among 24 cases, 11 were misdiagnosed. The average air conduction heating threshold from 0.25 to 6 kHz were between 60.2 and 66.5 dB HL. The average bone conduction heating threshold were 40.5 to 58.6 dB HL. The hearing of all ears was improved satisfactorily after treatment. The audiogram showed sensorineural hearing loss in 9 ears, mixed hearing loss in 19 ears. Tempanograms in 20 cases(24 ears) were all B type. Conclusion The reason of sudden hearing loss in these patients was possibly that the effusion in tympanum affected the phase-difference between the round window and the oval window. The audiogram in these patients was not specific. The suspected causes of misdiagnosis were discussed.