鼓膜完整的单耳传导性聋78例临床分析  

Clinical analysis of 78 cases of monaural conductive hearing loss with a normal tympanic membrane

作　　者：康琦[1] 吴同祥[1] 石柱[1] 熊灵峰[1] 

机构地区：[1]凉山州第一人民医院耳鼻咽喉科,四川西昌615000

出　　处：《海南医学》2018年第1期123-125,共3页Hainan Medical Journal

摘　　要：目的探究鼓膜完整的单耳传导性聋患者的发病类型、临床表现、听力学特征以及影像学特点,并观察其临床治疗效果。方法回顾性分析2013年2月至2016年5月凉山州第一人民医院收治的78例鼓膜完整的单耳传导性聋患者的发病类型、临床表现、颞骨CT结果、术中探查以及手术听力重建结果,以鼓室探查结果为基础进行术前纯音测听、中耳共振频率以及静态声导抗的结果分析。结果结合手术资料发现,78例患者中先天性中耳畸形37例(47.4%)、耳硬化症25例(32.1%)、先天性中耳胆脂瘤9例(11.5%)、先天性中耳胆脂瘤合并听骨链畸形3例(3.8%)以及外伤致传导性聋4例(5.1%);影像学检测结果显示,颞骨CT对先天性中耳畸形、耳硬化症、先天性中耳胆脂瘤诊断率分别为41.2%、50.0%及83.7%,差异具有统计学意义(P<0.05),但两两比较中对先天性中耳畸形和耳硬化症的诊断率差异无统计学意义(P>0.05);听力重建术后患者平均气导阈值以及平均气骨导差均有所降低,患者治疗效果明显,但组间比较差异无统计学意义(P>0.05)。结论鼓膜完整的单耳传导性聋主要发病类型包括先天性中耳畸形、耳硬化症以及先天性中耳胆脂瘤,手术重建听力对于鼓膜完整的单耳传导性聋患者有良好的治疗效果。Objective To investigate the pathogenetic type, clinical manifestation, audiological characteristics and imaging features of patients who have suffered from monaural conductive hearing loss with a normal tympanic membrane, and to observe their clinical therapeutic effectiveness. Methods The pathogenetic types, clinical manifestations,CT findings of temporal bone, intraoperative exploration and surgical hearing reconstruction in 78 patients who have suffered from monaural conductive hearing loss with a normal tympanic membrane treated in our hospital from February2013 to May 2016 were analyzed retrospectively. Based on exploration of the tympanic cavity, the results of preoperative pure tone audiometry, middle ear resonance frequency and static acoustic impedance were analyzed. Results According to the surgical data, there were 37 cases（47.4%） of congenital middle ear malformation, 25 cases（32.1%） of ear sclerosis, 9 cases（11.5%） of congenital middle ear cholesteatoma, 3 cases（3.8%） of congenital middle ear cholesteatoma with ossicular chain deformity, and 4 cases（5.1%） of post-traumatic conductive hearing loss. The results of imaging examination showed the diagnostic results of temporal bone CT in congenital middle ear malformation, ear sclerosis and congenital middle ear cholesteatoma were 41.2%, 50.0% and 83.7% respectively. The differences on all pairwise comparisons among groups were statistically significant（P0.05）, but there was no significant difference in the diagnosis of congenital middle ear malformation and ear sclerosis（P0.05）. The mean air conduction threshold and mean air barrier were decreased after hearing reconstruction, the treatment effects were obvious, but there were no significant differences on all pairwise comparisons among groups. Conclusion The main types of monaural conductive hearing loss with a normal tympanic membrane include congenital middle ear deformity, ear sclerosis and congenital middle ear cholesteatoma. Surgical reconstruction for the patients who

关 键 词：鼓膜完整 单耳传导性聋 发病类型 临床表现 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]