慢性中耳炎患者鼓室成形术后耳鸣、听力变化及影响耳鸣相关因素分析

Analysis of factors related to tinnitus,hearing changes and tinnitus in patients with chronic otitis media after tympanoplasty

目的:探讨鼓室成形术术后慢性中耳炎患者耳鸣、听力变化,并分析影响耳鸣变化的相关因素。方法:选取114例慢性中耳炎患者为研究对象,根据术前是否耳鸣将其分为术前耳鸣组(n=60)与术前无耳鸣组(n=54)。所有患者均行鼓室成形术,随访6个月;统计手术前后患者耳鸣症状及听力的变化情况;分析影响患者耳鸣改善的相关因素。结果:与术前相比,术后6个月术前耳鸣组耳鸣分级显著改善(P<0.01);与术前相比,术后6个月术前耳鸣组功能性、情感性、严重性等THI量表评分显著下降(P<0.01)。术前两组Pre-AC、Pre-BC、Pre-ABG水平比较无统计学差异(P>0.05),术后6个月时两组Post-AC、Post-BC、Post-ABG均显著下降(P<0.05或P<0.01),但两组间比较无统计学差异(P>0.05)。疾病类型为胆脂瘤型、活动型、静止型,病程分别<5年、≥5年及是否使用电钻对耳鸣改善情况并无影响(P>0.05)。结论:鼓室成形术术后慢性中耳炎患者耳鸣症状得到显著改善,听力水平大幅度提升,但疾病类型、病程长短、是否使用电钻或与耳鸣变化无关。

Objective：To investigate the changes of tinnitus and hearing in patients with chronic otitis media after tympanoplasty, and to analyze the related factors affecting the change of tinnitus. Methods：114 patients with chronic otitis media were divided into preoperative tinnitus group （ n =60） and preoperative no tinnitus group （ n =54） according to whether tinnitus before operation. All patients underwent tympanoplasty, and followed up for 6 months; and the changes of tinnitus symptoms and hearing pre-operation and post-operation were analyzed; the factors related to tinnitus changes in patients were analyzed. Results：Compared with pre-operation, the tinnitus grade in preoperative tinnitus group improved significantly 6 months post-operation;the scores of functional, affective, severity of THI scales in preoperative tinnitus group decreased significantly 6 months post-operation compared with those of pre-operation （ P 〈0.01）. There was no significant difference in the levels of Pre-AC, Pre-BC and Pre-ABG between 2 groups pre-operation （ P 〉0.05）. The Post-AC, Post-BC and Post-ABG decreased significantly in 2 groups at 6 months post-operation （ P 〈0.05 or P 〈0.01）, but there was no significant difference between 2 groups （ P 〉0.05）. The types of the disease were cholesteatoma type, active type and static type, the course of the disease was less than 5 years, more than 5 years and whether or not to use electric drill had no effect on the improvement of tinnitus in tinnitus patients （ P 〉0.05）. Conclusion：The tinnitus symptoms and hearing level of chronic otitis media patients are significantly improved after tympanoplasty, but the type of disease, duration, whether using electric drill or not is not related to tinnitus changes.