鼓室硬化听骨链病变对患者听力的影响  

Destrution of ossicular chain and it's impact on hearing of patients with tympanosclerosis

作　　者：陈静[1,2] 郑艳[1] 

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科,成都610041 [2]成都大学附属医院耳鼻咽喉科,成都610081

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第1期27-30,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨鼓室硬化听骨链病变对患者听力的影响。方法:回顾性分析115例鼓室硬化患者,按听骨链状况分成3组,听骨链完整活动度好组(A组)、听骨链完整固定组(B组)及听骨链中断组(C组),分析比较3组的听力学特点。结果:平均气导听阈(PTA)及1、2、4kHz气导听阈在A、B、C组间差异有统计学意义(P<0.01);气骨导差(ABG)在A、B组与C组之间差异有统计学意义(P<0.01),A、B组间ABG比较差异无统计学意义(P>0.01);A、B组0.5、1.0kHz与2.0、4.0kHz气导听阈差异有统计学意义(P<0.01),而C组0.5、1.0kHz与2.0、4.0kHz气导听阈差异无统计学意义(P>0.01);平均骨导值及1、2、4kHz骨导值在A组与B、C组间差异有统计学意义(P<0.01),而在B、C组之间差异无统计学意义(P>0.01);Carchart切迹出现率很低(10/115,8.7%),且在3组出现的概率相等(P>0.01)。结论:PTA≥(54.31±13.19)dB HL出现听骨链固定,PTA≥(63.90±20.29)dB HL出现听骨链中断;ABG≥(33.23±8.49)可以判断听骨链中断;上升型气导曲线预示听骨链可能连续尚处于固定状态,而平坦型气导曲线预示听骨链可能中断。Objective：To study the destruction ossicular chain＇s impact on hearing of patients with tympano- sclerosis. Method：A restrospective review was conducted in 115 patients with tympanosclerosis, all patients were devided into 3 groups, including normal ossicular chain structure（A group）, fixed ossicular chain（B group） ,and in- terrupted ossicular chain（C group）. The audiological feature of the patients were compared between the 3 group. Result：Difference were significant for PTA,0. 5,1. 0,2. 0,4. 0 kHz air conduction threshold between 3 group（P〈0.01）. Difference were significant for air bone gap（ABG） between A,B groups and C group（P〈0.01） ,there was no difference for ABG between A and B group（P〉0.01）. Difference were significant for air conduction threshold between 0.5,1.0 kHz and 2,4 kHz in A,B groups（P〈0. 01）,but there was no significant for same data in C group（P〉0.01）. Difference were significant for average bone conduction, 1,2,4 kHz bone-conduction threshold between A group and B,C group（P〈0.01）. The rate of Carchart notch was low and had no difference between 3 group（P〉0.01）. Conclusion：The ossicular chain was fixed in patients who＇s PTA≥（54.31±13.19）dB HL and was interrupted who＇s PTA≥（63.90±20.29）dB HL or ABG≥（33.23±8.49）dB HL. The rising shaped curve in air-conduction audiograph may indicate the ossicular chain was fixed, and the smoothshape curve may indicate the ossicular chain was interrupted.

关 键 词：鼓室硬化 听骨链 气导听阈 骨导听阈 气骨导差 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]