伴骨导听力下降的分泌性中耳炎临床特征及疗效分析  

Clinical Characteristics and Treatment Outcomes of Secretory Otitis Media with Bone Conductive Hearing Loss

作　　者：徐敏 冯永 敬前程[1,2] 杨中纯 文杰[1,2] 康晓明[1,2] 邵甸然 龚巍 XU Min;FENG Yong;JING Qiancheng;YANG Zhongchun;WEN Jie;KANG Xiaoming;SHAO Dianran;GONG Wei(Department of Otolaryngology Head and Neck Surgery,Affiliated Changsha Central Hospital,,University of South China Hengyang Medical School,Changsha,Hunan 410018,China;Institute of Otolaryngology Head and Neck Surgery,University of South China,Changsha,Hunan 410018,China)

机构地区：[1]南华大学附属长沙中心医院,耳鼻咽喉头颈外科,长沙410018 [2]南华大学耳鼻咽喉头颈外科研究所,长沙410018

出　　处：《中华耳科学杂志》2023年第1期52-56,共5页Chinese Journal of Otology

基　　金：湖南省重点研发计划项目(2020SK2106);南华大学人才启动项目(201RGC002);南华大学医学临床研究4310计划;湖南省卫生健康委科研计划项目(20201960);长沙市自然科学基金项目(kq2007050)。

摘　　要：目的探讨伴有骨导听力下降的分泌性中耳炎患者的临床特征及疗效,分析其可能原因,为临床诊治提供借鉴。方法分析2018年11月至2022年3月于我院接受治疗的23例(31耳)伴骨导听力下降的分泌性中耳炎患者的一般临床资料、治疗方案及疗效。结果患耳侧别:双耳8例,左耳11例,右耳4例;伴随症状:耳鸣16耳,耳闷14耳,耳痛4耳,眩晕3耳;鼓室导抗图:“B”型图27耳,“C”型图3耳,“AS”型图1耳;纯音听阈:入院气导平均听阈(59.9±18.7)dB HL,骨导平均听阈(34.7±14.6)dB HL,治疗后气导平均听阈(42.6±16.3)dB HL,骨导平均听阈(26.9±12.3)dB HL;治疗方案:所有患者入院后均予以鼻喷激素、粘液促排剂、营养神经药物等综合治疗;疗效:痊愈11耳(35.5%),有效6耳(19.4%),无效14耳(45.1%)。结论分泌性中耳炎患者可出现骨导听力下降,其具体机制尚不明确,出现骨导听力下降者,其听力损失程度一般较重,耳鸣为其常见伴随症状,确诊后应以综合治疗方案积极治疗,具有一定疗效。临床需引起重视,避免误诊及漏诊。Objective To report clinical characteristics and treatment outcomes of secretory otitis media with bone conductive hearing loss for improvement of understanding possible causes,diagnosis and treatment.Methods General clinical data,treatments and outcomes in 23 cases(31 ears)of secretory otitis media with bone conduction hearing loss treated at Affiliated Changsha Central Hospital,University of South China,from November 2018 to March 2022 were reviewed.Results Ears were bilaterally affected in 8 cases,on left side in 11 cases,and on right side in 4 cases.Accompanying symptoms included tinnitus(16 ears),ear fullness(14 ears),earache(4 ears)and vertigo(3 ears).Tympanogram was type"B"in 27 ears,type"C"in 3 ears and type"AS"in 1 ear.Pure-tone air conduction hearing threshold was 59.9±18.7 dB HL and bone conduction hearing threshold was 34.7±14.6 dB HL before treatment.Post-treatment air conduction threshold was 42.6±16.3 dB HL and bone conduction hearing threshold was 26.9±12.3 dB HL.Treatments included nasal glucocorticoid,mucus excretion promoter and nerve nourishing agents.After treatment,hearing returned to normal in 11 ears,improved in 6 ears and showed no recovery in 14 ears.Conclusion Specific mechanisms for bone conduction hearing loss in secretory otitis media are not clear at present.Patients with bone conduction hearing loss generally have severe hearing loss with tinnitus as a common accompanying symptom.These patients should be aggressively treated with comprehensive combined therapies for potential improvement.Attention should be paid to avoid misdiagnosis and missed diagnosis.

关 键 词：分泌性中耳炎 骨导下降 临床特征 疗效 

分 类 号：R764[医药卫生—耳鼻咽喉科]