慢性化脓性中耳炎患者听骨链病变与听力变化的关系  

Relation between ossicular chain destruction and hearing change in patients with chronic suppurative otitis media

作　　者：刘谦虚[1] 刘均辉 赵晓明[1] 窦晓辉[1] 刘劲[1] 熊彬彬[1] 

机构地区：[1]暨南大学医学院第三附属医院(珠海市人民医院)耳鼻咽喉头颈外科,广东珠海519000 [2]江西省宜丰县中医院麻醉科,江西宜丰336300

出　　处：《中国耳鼻咽喉颅底外科杂志》2011年第1期37-40,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨慢性化脓性中耳炎(chronic suppurative otitis media,CSOM)患者听骨链病变特点及其与听力受损的关系。方法对146例CSOM患者术前行纯音测听、检查鼓膜穿孔部位,术中显微镜观察听骨链病变。结果 7 9例鼓膜紧张部穿孔患者听骨链完好3 6例(45.6%)、受破坏(中断或固定)43例(54.4%);67例松弛部穿孔患者听骨链完好13例(19.4%)、受破坏54例(80.6%),两组差异显著(P<0.01)。听骨链破坏组与完好组比较,各语音频道(0.5、1、2、4 kHz)气导听阈均升高(P<0.01),骨导听阈仅在2 kHz有明显升高(P<0.05),语音频道总气骨导差增大(P<0.01)。结论①CSOM紧张部穿孔者听骨链受损程度低于松弛部穿孔者。②听骨链破坏主要影响CSOM患者的气导听阈,骨导阈值仅在听骨链共振频率2 kHz处有影响。Objective To study the characteristics of destructive ossicular chain and its impact on hearing impairment in patients with chronic suppurative otitis media（CSOM）.Methods In 146 patients with CSOM,the pure tone audiometry and perforation of ear drum were observed before operation and the destruction of ossicular chain was observed with microscope during operation.Results The ossicular chains of 36 cases（45.6%） were normal and 43（54.4%） were abnormal in 79 patients with pars tensa perforation of ear drum;while 13 cases（19.4%） were normal and 54（80.6%） were abnormal in 67 patients with pars flaccida perforation.Difference was significant between the two groups（P〈0.01）.Compared with normal ossicular chain group,the air conduction threshold and average air-bone gap at speech frequencies（0.5,1.0,2.0,4.0 kHz） of abnormal ossicular chain group were significantly higher（P〈0.01）,but bone conduction threshold was higher only at 2kHz（P〈0.05）.Conclusion ① Ossicular chain destruction in CSOM patients with pars tensa perforation of ear drum is slight.② The destruction of ossicular chain has obvious impact on air conduction threshold and only impact on bone conduction threshold at 2.0 kHz,which is the resonant frequency of ossicular chain.

关 键 词：慢性化脓性中耳炎 听骨链 气导 骨导 听力 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]