中耳变压疗法及相关处理治疗成人中耳负压的疗效观察

The observation of curative effect of middle ear pressure transformation therapeutics and the relevant management for adults negative middle ear pressure

目的 :探讨用中耳变压疗法 (MEPTT)治疗成人中耳负压 (NMEP)的效果。方法 :采用MEPTT治疗 31例 (42耳 )成人NMEP患者 ,并对其中 2 6例伴有鼻腔、鼻咽部炎症病变的患者给予抗炎、抗过敏及引流治疗 ,随访 0 5～ 1年。结果 :显效 10耳(2 3 81% ) ,有效 2 4耳 (5 7 14 % ) ,无效 8耳 (19 0 5 % ) ,总有效率为 80 95 % (34 4 2 ) ;治疗后鼓室压力由 (- 2 2 0 36± 6 5 0 0 )daPa提高至 (- 5 0 6 0± 88 2 6 )daPa ,静态声顺值由 (0 36± 0 2 4 )ml增大至 (0 4 7± 0 2 9)ml均较治疗前有明显改善 (P <0 0 1) ,外耳道容积由(1 10± 0 2 5 )ml增加至 (1 17± 0 30 )ml但较治疗前无显著性差异 (P >0 0 5 ) ;气导语言频率平均听阈值由 (39 6 4± 17 18)dBHL下降至 (2 7 0 5± 15 81)dBHL ,气骨导差值由 (18 93± 11 0 7)dB减小至 (12 0 8± 9 88)dB ,高频气导听阈平均值由 (5 3 89± 2 2 73)dBHL下降至 (39 2 5± 2 4 2 7)dBHL ,均较治疗前有明显改善 (P <0 0 1) ,无不良副反应发生。结论 :本疗法能够明显减轻成人中耳负压 ,改善听力 ,操作上安全 ,简便 ,值得在临床上推广应用。

Objective:To investigate the therapeutic effect of middle ear pressure transformation therapeutics(MEPTT) for adults negative middle ear pressure(NMEP).Methods:31 cases(42ears) were treated by MEPTT.Among them,26 cases were treated by antibiolics,decongestants or antiinflammatory preparations.31 cases were followed up for 6 to 12 mothes.Results:the overall effective(excellent/good) rate was 80 95%(excellent 23 81%,good 57 14%).After treatment,the middle ear pressure increased from( 220 36±65 00)daPa to( 50 60±88 26)daPa,the compliance maximum static increased from(0 36±0 24)ml to(0 47±0 29)ml.After treatment,the recorded parameters showed obvious therapeutical effect(P<0 01).The volume of external auditory meatus extend from(1 10±0 25)ml to(1 17±0 30)ml,but there was not a significant difference before and after treatment(P>0 05).The pure tone threshold(0 5?1?2?3KHZ) average dropped from(39 64±17 18)dBHL to(27 05±15 81)dBHL,the air bone gap(ABG) dropped from(18 93±11 07)dB to(12 08±9 88)dB,the high frequency hearing losses(4?6?8KHZ) average dropped from(53 89±22 73)dBHL to(39 25±24 27)dBHL.After treatment,the recorded parameters showed obvious therapeutical effect(P<0 01).All treatments were well tolerated,and no serious adverse events occurred.Conclusion:The results suggest that the curative effect of MEPTT and the relevant management in the treatment for adults NMEP is satisfactory and safety,It is recommended for the treatment of adults NMEP as a concervative method.