先天性中外耳畸形患者纯音听力特点分析

Characteristics of Pure Tone Audiometry in Patients with Congenital Outer and Middle Ear Malformation

目的分析先天性中外耳畸形患者纯音听力特点。方法回顾性分析213例(253耳)先天性中外耳畸形患者的纯音听力特点。结果纯音测听显示传导性耳聋198耳(78.26%)、混合性耳聋53耳(20.95%)、感音神经性耳聋2耳(0.78%)。将语频段0.5KHz、1k Hz、2KHz、4k Hz中任一频率未引出骨导或气导听力的患者剔除后余206例(246耳),平均气导阈值进行分析:以中重度耳聋(55d-70d B HL)51.63%(127/246),重度耳聋(71-90d B HL)33.74%(83/246)为主;其中传导性耳聋和混合性耳聋中重度,重度所占比例分别为59.60%(118/198),26.77%(53/198);18.75%(9/48),62.50%(30/48)。在56-80 d B HL范围内传导性耳聋、混合性耳聋所占比例分别为82.83%(164/198)、58.33%(28/48)。对混合性耳聋骨导纯音测听结果分析示:主要在2KHz处骨导听力有下降,占72.92%,平均阈值为30.42±7.84d B HL(10-60 d B HL),结论先天性中外耳畸形患者主要表现为传导性耳聋,以中重度、重度耳聋为主。骨导听力损失主要发生在2KHz,在2KHz处平均骨导听阈有轻度下降。

Objective To report characteristics of pure tone audiometry in patients with congenital outer and middle ear malformation.Methods Characteristics of pure tone hearing tests in 213 cases(253 ears)of congenital outer and middle ear malformations were retrospectively reviewed.Results On pure tone testing,198 ears(78.26%)showed conductive deafness,53 ears(20.95%)showed mixed deafness,and only 2 ears(0.78%)showed sensorineural deafness.Excluding frequencies at which no response could be induced,among 206 cases(246 ears),the average air conduction threshold indicated moderate-severe(56-70 dB HL)(51.63%,127/246)or severe(71-90 dB HL)(33.74%,83/246)deafness in most ears.Of ears with conductive deafness,59.60%(118/198)showed moderate-severe loss and 26.77%(53/198)showed severe loss,whereas 18.75%(9/48)of ears with mixed deafness showed moderate-severe loss and 62.50%(30/48)showed severe loss.Among ears showing 56-80 dB HL hearing loss,82.83%(164/198)demonstrated conductive deafness and 58.33%(28/48)demonstrated mixed deafness.Bone conduction hearing loss happened mainly at 2 kHz(72.92%)at a mean threshold of 30.42±7.84 dB HL(10-60 dB HL).Conclusions Patients with congenital outer and middle ear malformation show mainly moderate-severe or severe conductive deafness,with slight bone conduction hearing loss happening mainly at 2 kHz.