卡哈切迹在传导性耳聋相关疾病术前评估中的意义  

Significance of Carhart Notch in Preoperative Evaluation of Conductive Deafness Related Diseases

作　　者：龙朝庆 黄冠江 卢标清 LONG Chaoqing;HUANG Guanjiang;LU Biaoqing(Department of Otorhinolaryngology Head and Neck Surgery,Zhongshan Hospital of Tradional Chinese Medicine,Guangzhou University of Chinese Medicine,Zhongshan,Guangdong 528400,China)

机构地区：[1]广州中医药大学附属中山中医院耳鼻咽喉头颈外科,中山528400

出　　处：《中华耳科学杂志》2023年第4期493-497,共5页Chinese Journal of Otology

摘　　要：目的探讨卡哈切迹(Carhart Notch,CN)在传导性耳聋相关疾病手术术前评估中的意义。方法本研究纳入2020年~2021年在广州中医药大学附属中山中医院耳鼻咽喉头颈外科因传导性耳聋住院手术病人291例(320耳),其中慢性化脓性中耳炎161耳,鼓室硬化症28耳,耳硬化症21耳,中耳胆脂瘤39耳,先天性听骨链畸形6耳,分泌性中耳炎65耳。根据术前纯音听阈测定,按有无CN分为A组(有CN组)及B组(无CN组)。结果A组39耳(12.2%),B组281耳(87.8%)。A组中3例慢性化脓性中耳炎及3例中耳胆脂瘤病例术中均见有圆窗封闭,8例鼓室硬化症、21例耳硬化症及1例先天性听骨链畸形术中均见有镫骨底板固定。B组病例术中探查两窗活动均正常。结论CN的出现提示镫骨底板或圆窗活动受限。因此,CN在传导性耳聋相关疾病的术前评估中有重要临床意义,能辅助术前手术方案的制定。Objective To determine the significance of Carhart Notch(CN)in preoperative evaluation of conductive deafness related diseases.Methods This study included 291 patients(320 ears)hospitalized for conductive deafness in our department from 2020 to 2021,including 161 ears with chronic suppurative otitis media,28 ears wih tympanic sclerosis,21 ears with otosclerosis,39 ears with middle ear cholesteatoma,6 ears with congenital ossicular chain malformation and 65 ears with secretory otitis media.They were grouped based on the presence of CN on preoperative audiograms.Results CN was present in 39 ears(12.2%)and absent in 281 ears(87.8%).Lesions in those with CN included round window occlusion(3 cases of chronic suppurative otitis media and 3 cases of middle ear cholesteatoma)and stapes floor fixation(8 cases of tympanic sclerosis,21 cases of otosclerosis and 1 case of congenital ossicular chain malformation).Mobility of round window and oval window was normal in all cases without CN.Conclusion CN on audiogram appears to indicate limited mobility of stapes footplate or round window and may bear important clinical significance in the preoperative evaluation of conductive deafness.It can used to assist formulation of appropriate surgical treatment plans.

关 键 词：卡哈切迹 传导性耳聋 术前评估 

分 类 号：R764[医药卫生—耳鼻咽喉科]