中耳不张对听力的影响及早期治疗效果观察

Impact of middie ear atelectasis on hearing and effects of early treatment

目的探讨中耳不张对患者听力的影响及早期治疗。方法回顾分析2010年12月~2014年02月我院82例中耳不张Ⅰ~Ⅱ级的患者,检查纯音听阈和鼓室压力变化,采用保守治疗和微型管植入术治疗两种治疗方法。结果患者都有耳闷症状,鼓室图提示鼓室负压〈-100dapa,气导阈曲线与骨导阈曲线不平行,低频气骨导差距最大,骨导在2k Hz听阈提高。42例保守治疗患者中只有8例保守治疗2周好转,其余患者保守治疗2周无明显效果。鼓膜微型管置入术置入术40例,其中33例置管后症状即刻消失,7例置管后症状无改善。结论中耳不张患者早期耳闷症状明显而且伴有听力下降,以低频下降为主,应早期治疗,给予微管置入术治疗能有效解除负压改善症状。

Objective To study the effects of middle ear atelectasis on hearing and the optimal treatment modality forearly-stage middle ear atelectasis. Methods A retrospective study was conducted on 82 patients diagnosed with middle ear atelectasis in stages I or II and treated with either conservative therapies or tympanostomy microtube placement at our hospi-tal between December 2012 and February 2014. Results Manifestations of middle ear atelectasis included aural fullness, negative tympanic pressure greater than 100 dapa, air conduction thresholds not paralleling bone conduction thresholds withthe largest gap at low-frequencies, and better bone conduction thresholds at 2 kHz. Among the 42 patients receiving conser- vative therapies for 2 weeks, only 8 demonstrated improvement; while of the 40 patients treated with tympanostomy micro-tube placement, immediate symptom relief was seen in 33 and treatment was ineffective in only 7 patients. Conclusions Patients with middle ear atelectasis show symptoms of ear fullness associated with hearing loss, especially at low frequencies.Early treatment is important and microtube placement is an effective treatment.