鼓室硬化病变程度与影像学及听力学相关性分析  

Analysis of the correlation between degree of tympanosclerosis lesions with imaging and audiology

作　　者：王一红[1,2] 郑昊[1,2] 王增林[1,3] 李瑞玉[1,2] 

机构地区：[1]福建医科大学省立临床医学院 [2]福建省立医院耳鼻咽喉科,福建福州350001 [3]福建省立医院放射科,福建福州350001

出　　处：《中国耳鼻咽喉头颈外科》2013年第11期563-565,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨高分辨CT影像、术前听力在鼓室硬化的诊断、术前评估听骨链完整性及镫骨活动度中的价值。方法回顾性分析经手术证实的81例鼓室硬化患者术前颞骨高分辨CT影像资料、术前听力平均气骨导差、术中硬化灶分布及听骨链完整性、镫骨活动度等数据,进行Spearson秩相关分析及Logistic回归分析。结果高分辨CT影像与术中所见符合率87.7%,平均气骨导差与听骨链完整性相关系数r=-0.407,P<0.01;镫骨病灶与镫骨活动度r=-0.287,P<0.01;镫骨显影与镫骨活动度r=0.480,P<0.01;平均气骨导差与镫骨活动度r=-0.265,P<0.05;Logistic回归分析提示在调整混杂因素后,平均气骨导差在镫骨周围病灶、听骨链完整性、镫骨活动度、硬化灶与听骨粘连中仍有明显差异,有统计学意义(P<0.05)。结论颞骨高分辨CT影像可以清晰显示鼓膜和鼓室内的硬化斑块,平均气骨导差可以大致判断听骨链完整性、镫骨活动度情况,为术前评估病变程度、制定手术方案具有指导意义。OBJECTIVE To investigate the diagnostic value of HRCT imaging and preoperative hearing for tympanosclerosis, preoperative assessment of ossicular chain integrity and the degree of stapes mobility. METHODS A retrospective analysis with Spearson rank correlation analysis and Logistic regression was used for the data of preoperative HRCT images of temporal bone, preoperative hearing air bone gap （ABG） , distribution of in sclerostic lesions and ossicular chain integrity as well as stapes motion from 81 cases of tympanosclerosis confirmed by operation. RESULTS The coincidence rate of HRCT images and intraoperative finding was 87.7%. The correlations of ABG and ossicular chain integrity, stapes lesions and stapes mobility, stapes image and stapes mobility, ABG and stapes mobility were r=-0.407, P〈0.01; r=-0.287, P〈0.01; r=0.480, P〈0.01 and r=-0.265, P〈0.05 respectively. After adjusting for confounding factors Logistic regression analysis showed that the mean value of ABG had statistical significance in the lesions around the stapes, ossicular chain integrity, stapes mobility, the sclerostic lesions and ossicular adhesion, P〈 0.05. CONCLUSION Temporal bone HRCT imaging can clearly show the tympanic membrane and the intratympanic sclerostic plaques. ABG can be used to judge the integrity of ossicular chain and activity of stapes that will be a useful guide for preoperative evaluation of the severity of disease and surgical planning.

关 键 词：中耳 硬化 体层摄影术 X线计算机 听觉丧失 传导性 测听法 纯音 

分 类 号：R764[医药卫生—耳鼻咽喉科]