分泌性中耳炎合并双耳感音神经性耳聋的临床诊治

Clinical diagnosis and treatment of secretory otitis media combined with binaural sensorineural hearing loss

目的:探讨分泌性中耳炎合并双耳感音神经性耳聋的临床诊治。方法:选择2013年1月~2016年1月在我院进行治疗的分泌性中耳炎合并双耳感音神经性耳聋患者20例,40只患耳(A组),另选择同期在我院收治的单纯分泌性中耳炎患者20例,共40只患耳(B组)。比较两组患者治疗后中耳炎的临床疗效以及听阈改善情况,分析两组患者在治疗期间不良反应的发生情况。结果:治疗1个月后,两组中耳炎的临床疗效无显著差异,治疗3个月后,B组的临床疗效显著优于A组,其中B组的临床疗效与1个月相比显著提高,而A组改善不明显;治疗1个月后,两组患者的听阈改善情况差异不显著,治疗3个月后,B组的听阈改善显著优于A组,其中B组与1个月相比显著提高,而A组改善不显著;B组术后感染、中耳粘连、鼓室硬化的发生率显著低于A组。结论:鼓膜置管术联合腺样体切除术治疗分泌性中耳炎合并双耳感音神经性耳聋虽然可以缓解患者中耳炎的临床症状,改善听力,但疗效有限,患者术后恢复缓慢,临床应及时诊断并对症治疗分泌性中耳炎,预防感音神经性耳聋的发生。

Objective To investigate the clinical diagnosis and treatment of secretory otitis media combined with bilateral sensorineural hearing loss. Methods From January 2013 to January 2016, 20 patientsof secretory otitis media with bilateral sensorineural hearing loss were treated in our hospital, in all 40 ear were disorders, considered as A group. selected 20 cases of onlysecretory otitis media in patients with a total of 40 affected ears at same period in our hospital, considered as Bgroup. The improvement of otitis media clinical efficacy and threshold were compared between the two groups after treatment, analysis of two groups of patients during treatment of adverse reactions. Results After 1 months of treatment, there was no significant difference between the two groups of clinical curative effect of middle ear arthritis. After 3 months of treatment, the clinical curative effect of B group was significantly higher than A group, the clinical efficacy of B group increased significantly compared with 1 months, A group; no obvious improvement after 1 months of treatment. Two groups of patients with improved threshold the situation, the difference was not significant. After 3 months of treatment, B group improved threshold was higher than A group. compered with after 1 months of treatment, after 3 months of treatment was improved significantly in B group, but A group is not significantly improved. The infection, postoperative adhesion, the incidence of tympanosclerosis in group B were lower than that in A group. Conclusion Tympanostomy tube surgery combined with adenoidectomy in treatment of secretory otitis media with bilateral sensorineural hearing loss although can alleviate clinical symptoms of patients with otitis media, and improvement of listening, but the effect was limited and the postoperative recovery was slow. Timely diagnosis and clinical treatment for secretory otitis media were needed, preventingfrom the sensorineural deafness.