单侧听力耳中耳炎手术经验再探讨

Surgical experience of otitis media in patients with one hearing ear only

目的 探讨单侧听力耳中耳炎（包括胆脂瘤）患者施行手术治疗的效果及经验。方法 回顾性分析2000年5月-2013年1月期间手术治疗的13例单侧听力耳中耳炎患者的手术和随访资料,并与2000年前的15例患者（以下称“前组”）结果比较。结果 随访6-156个月,平均（84.55±56.84）个月。随访结束时13例均为干耳。术后气骨导差（GAP）、气导（AC）较术前降低,差异有统计学意义（P〈0.01）。手术有效率为92.31%（12/13）,其中成功11例（84.62%）,包括GAP〈10 d B HL 4例;11-20 d B HL7例;其余2例中,1例有效,1例听力无变化。术前、术后骨导（BC）差异无统计学意义（P〉0.05）。术后GAP差值〉20 d B HL者10例（76.92%）,〉30 d B HL者4例（30.77%）,而“前组”分别为6例（40.00%）和2例（13.33%）,较“前组”有所提高。结论 单侧听力耳中耳炎手术能获得安全和有效的结果,患者生活质量提高。

Objective To summarize the surgical experience of otitis media, as well as cholesteatoma of the middle ear, in patients with one hearing ear only. Methods A total of 13 patients with otitis media underwent operation between May 2000 and Jan 2013. The surgical and follow-up data were retrospectively collected and compared with those of 15 patients （ as pre-group ） who received surgical treatment before 2000. Results All patients achieved dry ear after fol- low-up（ ranged from 6 months to 156 months, averaged follow-up was 84.55 ±56.84 months） . The A-B GAP and air conduction （AC） were dropped after treatment compared with those before operation （P 〈 0.01 ）. The overall effective rate of operation was 92.31% （12/13）. In those with successful operation, 4 case with GAP 〈 10 dB HL, 7 cases with GAP between 11 and 20 dB HL, there was no significant difference in bone conduction （BC） before and after treatment （P 〉0.05）. The proportion of patients with GAP difference over 20 dB HL and 30 dB HL were 76.92% （ 10/13 ） and 30.77% （4/13）, which was significant higher than those of 40.00% （6/15） and 13.33% （2/15） in pregroup. Conclusion This study shows a more safe and effective outcome in surgical treatment otitis media in patients with one hearing ear only.