慢性中耳炎患者鼓室成形术后听力变化及耳鸣改善影响因素  

Hearing Changes and Influencing Factors of Tinnitus Improvement in Patients with Chronic Otitis Media after Tympanoplasty

作　　者：张娟 ZHANG Juan(People’s Hospital of Qichun County,Qichun 435300,China)

机构地区：[1]蕲春县人民医院,湖北蕲春435300

出　　处：《中外医学研究》2022年第18期124-127,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨慢性中耳炎患者鼓室成形术后听力变化及耳鸣改善影响因素。方法:回顾性分析2018年3月-2021年3月蕲春县人民医院采取鼓室成形术治疗的72例慢性中耳炎患者的临床资料。根据手术前是否伴有耳鸣将其分为伴有耳鸣组(n=34)和非伴有耳鸣组(n=38)。所有患者均给予鼓室成形术。评价伴有耳鸣组术前及术后6个月耳鸣严重程度、临床疗效、耳鸣改善情况。测定两组术前及术后6个月听力水平。统计伴有耳鸣组耳鸣改善有效和无效的例数,分析影响耳鸣改善相关因素。结果:两组术后6个月气导(AC)、骨导(BC)、气骨导差(ABG)水平均明显下降(P<0.05)。伴有耳鸣组术后6个月耳鸣严重程度明显优于术前(P<0.05)。术后6个月伴有耳鸣组功能性、情感性及严重性评分均低于术前(P<0.05)。耳鸣改善受咽鼓管炎症、鼓室黏膜纤维化、使用电钻、锤骨柄完整因素的影响(P<0.05)。结论:慢性中耳炎患者鼓室成形术后听力水平得到大幅度提高,耳鸣症状得到明显改善,慢性中耳炎患者耳鸣改善与疾病类型(活动型、胆脂瘤型、静止型)等因素的关系不大,受咽鼓管炎症、鼓室黏膜纤维化、使用电钻、锤骨柄完整性因素的影响。Objective:To investigate the hearing changes and influencing factors of tinnitus improvement in patients with chronic otitis media after tympanoplasty.Method:The clinical data of 72 patients with chronic otitis media treated by tympanoplasty in People’s Hospital of Qichun County from March 2018 to March 2021 were retrospectively analyzed.According to whether there was tinnitus before operation,the patients were divided into tinnitus group(n=34)and non tinnitus group(n=38).All patients were given the tympanoplasty.Evaluated the tinnitus severity,clinical efficacy and tinnitus improvement condition in the tinnitus group before and 6 months after operation.The hearing levels of the two groups were measured before and 6 months after operation.The effective and ineffective cases of tinnitus improvement in the tinnitus group were counted,and the related factors affecting tinnitus improvement were analyzed.Result:Air conduction(AC),bone conduction(BC)and difference of air and bone conduction(ABG)in both groups significantly decreased 6 months after operation(P<0.05).The severity of tinnitus in tinnitus group 6 months after operation was significantly better than that before operation(P<0.05).The functional,affective and severity scores of the tinnitus group 6 months after operation were lower than those before operation(P<0.05).Tinnitus improvement was affected by eustachian tube inflammation,tympanic mucosa fibrosis,use of electric drill,and the integrity of malleus handle(P<0.05).Conclusion:After tympanoplasty,the hearing level of patients with chronic otitis media has been greatly improved,and the tinnitus symptoms have been significantly improved.The improvement of tinnitus in patients with chronic otitis media has little to do with disease types(active,cholesteatoma,static)and other factors,which is affected by eustachian tube inflammation,tympanic mucosa fibrosis,the use of electric drill,and the integrity of malleus handle.

关 键 词：慢性中耳炎 鼓室成形术 听力变化 耳鸣 因素分析 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]