鼓室硬化患者的临床听力学分析  

Clinical audiology analysis in patients with tympanosclerosis

作　　者：舒繁[1] 谢南屏[1] 郭梦和[1] 万良财[1] 张宏征[1] 

机构地区：[1]南方医科大学珠江医院,广州510282

出　　处：《山东医药》2013年第19期21-24,共4页Shandong Medical Journal

摘　　要：目的探讨鼓室硬化患者临床听力学特点。方法回顾性分析102例(102耳)鼓室硬化病例的临床资料,其中Ⅰ型24耳,Ⅱ型30耳,Ⅲ型23耳,Ⅳ型25耳。分析各型患者术前纯音听阈测定言语频率平均气骨导差(ABG)及各频率(250、500、1 000、2 000 Hz)平均听阈,比较各型听力学特点。结果鼓室硬化Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型术前气骨导差分别为(25.97±4.42)、(37.83±6.95)、(39.64±5.43)、(39.2±7.42)dB,其中Ⅰ型与其他三型气骨导差比较,P均<0.05;各型气导曲线大致呈平坦型,Ⅱ型、Ⅲ型和Ⅳ型骨导曲线部分频率下降。所有病例中,74例为传导性耳聋,28例为混合性耳聋,39例听力图出现类似Carchart切迹改变,除Ⅰ型之外的几乎所有病例ABG>30 dB。结论鼓室硬化患者多呈传导性耳聋,ABG>30 dB可预示着听骨链病变;鼓室硬化Ⅱ型、Ⅲ型、Ⅳ型的听力下降程度与硬化灶的范围和程度无明显关系。Objective To investigate the clinical audiological characteristics in patients with tympanosclerosis. Methods A retrospective review was conducted in 102 patients with tympanosclerosis （ involving 102 ears ）. All the patients were divided into four groups, including （A） type I group （24 ears）, （B） type Ⅱ group （30 ears）, （C） type Ⅲ group （23 ears） and （D） type IV group （25 ears）. All the patients were followed up pre-operation through audiometric measurement （ the average hearing threshold at 0.5, 1.0, 2.0kHz HL）. Results The pre-operation mean air bone gap （ABG） in these groups were 25.97 ±4.42dB, 37.83 ±6.95dB, 39.64 ±5.43 dB and 39.2±7.42 dB. The hearing in group A was better than the other three groups （ all P 〈 0.05 ）. The difference in group B, group C and group D had no statistical significance （ P 〉 0. 05 ）. The AC hearing curve was substantially flat in each group, part of the frequency at BC hearing was profound with descending curve in group B, group C and group D. In all the patients, 74 ears suffered conductive hearing loss, 28 ears had mixed deafness, and Carchart-like notch changes were found in audiogram for 39 ears. Almost all the oth- er cases except group A, the ABG was greater than 30 dB. Conclusions Most of the patients with tympanosclerosis suffer conductive hearing loss; when ABG was greater than 30 dB, they may presage ossicular chain lesions. No significant relationship was found between the degree of hearing loss and the scope and extent of the sclerosis lesions in group B, group C and group D.

关 键 词：鼓室硬化 纯音听阈 听骨链 气骨导差 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]