不同年龄慢性中耳炎患者Ⅰ型鼓室成形术后咽鼓管功能变化与耳鸣的关系  

Relationship Between Eustachian Tube Function and Tinnitus after TypeⅠTympanoplasty for Chronic Otitis Media at Different Ages

作　　者：李兴程 徐静[1] LI Xingcheng;XU Jing(Department of Otology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院耳科,郑州450052

出　　处：《中华耳科学杂志》2025年第2期185-192,共8页Chinese Journal of Otology

摘　　要：目的探究不同年龄慢性中耳炎(chronic otitis media,COM)患者Ⅰ型鼓室成形术后咽鼓管功能变化与耳鸣的关系。方法回顾性选取郑州大学第一附属医院耳科2021年1月到2023年12月收治的行鼓室成形术的COM患者150例为研究对象,按照患者年龄分为A组、B组、C组,根据患者术前是否伴有耳鸣分为耳鸣组和无耳鸣组。比较COM患者临床资料、术前、术后1周、术后3月、术后6月七项咽鼓管功能障碍症状评分量表(sevenitem eustachian tube dysfunction questionnaire,ETDQ-7)评分、听力水平。分析耳鸣组临床疗效、耳鸣残障量表(tinnitus handicap inventory,THI)评分。多因素Logistic回归分析影响A组、B组、C组耳鸣的危险因素、ETDQ-7评分与耳鸣的关系。结果术后A组、B组、C组ETDQ-7评分、听力水平均高于术前,差异均有统计学意义(P<0.05),术后1周、术后3月、术后6月,A组、B组、C组ETDQ-7评分比较,差异有统计学意义(P<0.05),C组高于A组、B组,差异均有统计学意义(P<0.05)。耳鸣组与无耳鸣组性别、年龄、ETDQ-7评分、病程、气导听阈、气骨导差比较,差异均有统计学意义(P<0.05)。术后1周,A组、B组、C组治愈率分别为60.00%、25.00%、17.65%,差异有统计学意义(P<0.05),术后3月、术后6月,A组、B组、C组治愈率比较,差异无统计学意义(P>0.05)。耳鸣组术后THI评分显著下降。年龄、ETDQ-7评分、气导听阈、气骨导差是影响COM患者耳鸣的危险因素。咽鼓管功能与术前耳鸣相关,差异有统计学意义(P<0.05),存在独立相关性(OR=1.95,95%CI:1.86~2.05,P<0.01)。结论不同年龄COM患者鼓室成形术后ETDQ-7评分、听力水平均有所提高,咽鼓管功能与术前耳鸣显著相关,存在独立相关性,是影响患者耳鸣的危险因素。Objective To determine the relationship between eustachian tube function and tinnitus after type I tympanoplasty for chronic otitis media(COM)at different ages.Methods A total of 150 patients who underwent tympanoplasty for COM in the Department of Otology,First Affiliated Hospital of Zhengzhou University,from January 2021 to December 2023 were retrospectively selected divided into three groups based on age,and subgroups based on complaints of tinnitus before surgery.Clinical data,seven-item Eustachian Tube Dysfunction Questionnaire(ETDQ-7)scores and hearing levels before and 1 week,3 months and 6 months after surgery were compared.Clinical outcomes and Tinnitus Handicap Inventory(THI)results were also analyzed.Multivariate Logistic regression was used to identify risk factors for tinnitus,as wellas the relationship between ETDQ-7 score and tinnitus.Results Postoperative ETDQ-7 scores and hearing levels were higher in all groups compared to before surgery(P<0.05).At 1 week,3 months and 6 months after surgery,the ETDQ-7 score in group C was higher than that in groups A and B(P<0.05).Gender,age,ETDQ-7 score,disease course,air conduction threshold and air bone gap demonstrated statistically significant differences between patients with tinnitus and those without(P<0.05).At 1 week after surgery,the rates of complete resolution was 60.00%,25.00%and 17.65%for groups A,B and C,respectively,(P<0.05).The difference among the groups disappeared at 3 and 6 months after surgery(P>0.05).The THI score in patients with tinnitus decreased significantly after operation.Age,ETDQ-7 score,air conduction threshold and air bone gap were risk factors for tinnitus.Tubal function was correlated with preoperative tinnitus(P<0.05),which was an independent factor(OR=1.95,95%CI:1.86~2.05,P<0.01).Conclusion ETDQ-7 score and hearing level in patients with COM improve after tympanoplasty,regardless of age.Eustachian tube function is independent correlated with preoperative tinnitus,and therefore a risk factor for tinnitus.

关 键 词：慢性中耳炎 年龄 鼓室成形术 咽鼓管功能 耳鸣 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R764.45[医药卫生—临床医学]