慢性化脓性中耳炎患者耳内镜下鼓室成形术后短期听力恢复不良的危险因素研究  

Risk factors for poor short-term hearing recovery after tympanoplasty under otoendoscope in patients with chronic suppurative otitis media

作　　者：魏建初[1] 陈佩泽 朱含悦 何云生[1] Wei Jianchu;Chen Peize;Zhu Hanyue;He Yunsheng(Department of Otorhinolaryngology,Huzhou Central Hospital,Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州市中心医院耳鼻喉科,浙江湖州313000

出　　处：《中国内镜杂志》2025年第4期50-55,共6页China Journal of Endoscopy

摘　　要：目的 探讨慢性化脓性中耳炎(CSOM)患者接受耳内镜下鼓室成形术(TUO)后发生短期听力恢复不良的危险因素。方法 回顾性分析2020年1月-2023年10月于该院接受TUO治疗的260例CSOM患者的临床资料,术后随访3~6个月,根据是否发生听力恢复不良将患者分为:发生组(61例)和未发生组(199例)。比较两组患者的临床资料,采用Logistic回归模型分析影响CSOM患者TUO术后发生听力恢复不良的独立危险因素。结果 多因素Logistic回归分析结果显示,鼓膜张肌缺损(O^R=1.079,95%CI:1.054~1.105)、鼓室黏膜病变(O^R=1.196,95%CI:1.076~1.330)、咽鼓管不通(O^R=2.212,95%CI:1.339~3.654)、咽鼓管炎症(O^R=1.095,95%CI:1.047~1.146)、鼓室黏膜纤维化(O^R=2.423,95%CI:1.402~4.186)和术前鼓室内有脓性分泌物(O^R=1.070,95%CI:1.031~1.111)是导致CSOM患者TUO术后发生听力恢复不良的独立危险因素(P <0.05)。结论 CSOM患者TUO术后易发生短期听力恢复不良,与鼓膜张肌缺损、鼓室黏膜病变、咽鼓管不通、咽鼓管炎症、鼓室黏膜纤维化和术前鼓室内有脓性分泌物有关,临床可给予CSOM患者TUO术后针对性的防治措施,以避免术后短期听力恢复不良的发生。Objective To investigate the risk factors for the occurrence of short-term poor hearing recovery in patients with chronic suppurative otitis media(CSOM)underwent tympanoplasty under otoendoscope(TUO).Methods The clinical data of 260 patients with CSOM treated with TUO from January 2020 to October 2023 were retrospectively analyzed,the patients were followed up for 3 to 6 months after the operation,and were divided into the occurrence group(61 patients)and the non-occurrence group(199 patients)according to whether or not they experienced poor hearing recovery.The clinical data of patients in the two groups were compared,and the independent risk factors affecting the occurrence of poor hearing after TUO in CSOM patients were analyzed by Logistic regression model.Results The results of multivariate Logistic regression analysis showed that tensor tympani defects(OR=1.079,95%CI:1.054~1.105),tympanic mucosal lesions(OR=1.196,95%CI:1.076~1.330),auditory tube incompetence(OR=2.212,95%CI:1.339~3.654),auditory tube inflammation(OR=1.095,95%CI:1.047~1.146),tympanic mucosal fibrosis(OR=2.423,95%CI:1.402~4.186),and preoperative purulent secretion in the tympanic cavity(OR=1.070,95%CI:1.031~1.111)were the independent risk factors contributing to the development of poor hearing recovery after TUO in patients with CSOM(P<0.05).Conclusion The occurrence of short-term poor hearing recovery after TUO in patients with CSOM is related to tensor tympani defects,tympanic mucosal lesions,auditory tube incompetence,auditory tube inflammation,tympanic mucosal fibrosis,and preoperative purulent secretions in the tympanic cavity,and clinically targeted preventive and curative measures may be given to postoperative patients with CSOM after TUO in order to avoid the occurrence of postoperative short-term poor hearing recovery.

关 键 词：慢性化脓性中耳炎(CSOM) 耳内镜下鼓室成形术(TUO) 听力恢复不良 危险因素 

分 类 号：R746.21[医药卫生—神经病学与精神病学]