耳聋相关疾病与听力图分析讲座

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1、耳聋相关疾病与听力图分析Hearinglossdisease&audiogramanalysis耳的症状学Earsemeiology耳痛otalgia耳漏Otorrhea耳痒earitch耳鸣tinnitus耳聋hearingloss眩晕vertigo面瘫faceparalysis耳后肿胀tumefaction耳聋的分类按耳聋病发的时间分类antenatalpre-birthhearinglossinheritance1.先天性耳聋：出生以前的耳聋2.后天性耳聋：出生以后的耳聋postnatalaft

2、erbirthhearingloss遗传遗传非遗传非遗传耳聋的分类按病发的部位分类Hearinglossclassaccordingtoinflammationpart.1.蜗前聋：传导性耳聋，外耳、中耳病变。Pre-cochleahearingloss:conductivehearingloss,externalearandmiddleearhaveinflammation.2.蜗性聋：感应性耳聋，耳蜗本身病变。Cochleahearingloss:sensorineuralhearingloss,

3、thecochleahastheinflammation.3.蜗后聋：神经性耳聋，大脑听中枢病变。CentralHearingloss:sensorineuralhearingloss,nervecenteristhemorbidpart.感音神经性耳聋传导性耳聋耳聋的分类Conductivehearingloss传音性（传导性、蜗前聋）SensorineuralHearingloss感音神经性（蜗性、蜗后聋）Mixedhearingloss混合性CentrumHearingloss中枢性（蜗后聋）传

4、导性耳聋Conductivehearingloss正常听力图Thenormalaudiogram频率Frequencyonthex-axis声强Intensityonthey-axisFrequencyrange:125-8000HzIntensityrange:-10-120dB(airconduction)ExampleofConductivehearingloss传导性耳聋Conductivehearingloss1.骨导正常Boneconditionisnormal.2.气导下降Aircond

5、ition3.气骨导差>10dBA-Bgapismorethan10dB.传导性耳聋的听损程度传导性耳聋的听损程度1.鼓膜穿孔。ABG30dB左右2.鼓膜穿孔伴听骨链中断。ABG40dB左右3.鼓膜和听骨完全缺如。4.鼓膜完整伴听骨链中断。ABG60dB5.鼓膜完整+听骨链中断+卵圆窗封闭。6.外耳道堵塞。传导性耳聋的常见病变耳部畸形Earmalformations耵聍栓塞Impactedearwax外耳湿疹Acuteotitismedia外耳道炎Inflammationoftheearcanal外耳

6、道塌陷Dentoftheearcanal耳道扩大Expandoftheearcanal异物eyewinker鼓膜穿孔Perforatedeardrum流脓Purulence穿孔后愈合ScaroverafterPerforated肿瘤或胆脂瘤Exostosesandosteomas鼓膜疤痕Eardrumscar鼓膜硬化Eardrumsclerosis常见的中耳疾病化脓性中耳炎Suppurativeotitismedia分泌性中耳炎Secretoryotitismedia耳硬化症Otosclerosis听

7、骨链固定Fixationoftheossicularchain听骨链中断Interruptionoftheossicularchain鼓室硬化tympanasclerosis感音神经性耳聋Sensorineuralloss响度改变AlteredloudnessPoorersensitivitytosoftandintermediatesoundsSometimesincreasedsensibilitytoloudsounds失真Distortion(missingfrequencies)言语分辨率下

8、降Poordiscrimination(especiallyinnoisecondition)耳鸣Tinnitus伴随症状AssociatedproblemsSensorineuralhearingloss1.气骨导都下降。Airconductivedecline2.气导早期以高频下降为主，晚期低频也下降。Highfrequencydeclineatfirsttime,thenbothdecline.3.气骨导差<10dBThereisnoadistan