不同术式鼓室成形术后患者的听力分析

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1、听力学及言语疾病杂志2010年第18卷第3期215。听觉功能重建ll。不同术式鼓室成形术后患者的听力分析舒敏金晓杰王家东【摘要】目的探讨不同术式鼓室成形术对中耳增益的影响。方法研究对象为135例(137耳)慢性化脓性中耳炎患者，根据手术类型分为伴乳突切除术的鼓室成形术26例(26耳，I组)、不伴乳突切除术的鼓室成形术61例(62耳，II组)和单纯鼓膜修补术48例(49耳，III组)三组。比较三组患者干耳后平均听阈及各频率听阈改善情况，计算各组的中耳危险指数(middleearriskindex，MERI)

2、值，分析MERI值与术后疗效的相关性。结果II组较I组患者术后平均听阈明显降低(PO．05)，各组术后听力改善与MERI值无明显相关性。结论不伴乳突切除术的鼓室成形术对中耳增益效应影响显著，术后患者听功能改善明显，鼓室成形术后疗效与MERI值无显著相关性。【关键词】鼓室成形术；中耳增益机制；中耳危险指数值DOI：10．3969／j．issn．1006—7299．2O10．03．0

3、04【中图分类号】R764．92【文献标识码】A【文章编号11006—7299(2O10)03—0215一O3AnalysisofHearingResultsofPatientsafterDifferentTypeTympanoplastyShuMin，JinXiaojie，WangJiadong(OtoIaryngoIogyHeadandNeckSurgery，RenjiHospitalShanghaiJiaotongUniversitySchoolofMedicine，Shanghai，200001，

4、China)[Abstract]ObjectiveTheaimofthisstudyistOcomparethegainsaccomplishedfromdifferenttympanoplastybaseduponareviewofpatientrecords．MethodsThechartsof137patientswhounderwentdifferenttympano—plastyoperationswerereviewed．Theyweredividedintothreegroups．Group

5、I，26cases(26ears)oftympanoplastywithmastoidectomy；groupII，61cases(62ears)oftympanoplastywithmastoidectomy；groupIII，48cases(49ears)ofmyringoplasty．Thehearingoutcomesafterdryearwereanalyzed．NonparametricstatisticswasusedtOdeterminegroupdifferences．Aprobabil

6、ityvalueofP<0．05wasnoted．Themiddleearriskindexwasinvestigated．ResultsSignificantlyimprovedhearingresultswereobservedinthegroupoperatedbytympanoplastybutnotmastoidecto—my．TheresultsweresimilartOthoseofthemyringoplastygroup，especiallyatlowerfrequencies．Ther

7、ewasnosig—nificantcorrelationbetweenthehearingoutcomesandmiddleearriskindex．ConclusionThetympanoplastywithoutmastoidectomyisausefulsurgicaltechniqueasfarasthehearingresultsareconcerned．ThetypeofoperationisfoundtObeasignificantindependentprognosticfactor．[

8、Keywords]Tympanoplasty；Acousticpressuregain；Middleearriskindex(MERI)慢性化脓性中耳炎引起的鼓膜穿孔和听骨链受1资料与方法损可导致高达6O～7O分贝的传导性听力下降l1]。1．1一般资料选取因慢性化脓性中耳炎在上海鼓室成形术是迄今为止清除慢性化脓性中耳炎病灶、交通大学医学院附属仁济医院耳鼻咽喉头颈外科行重建中耳传音结构以提高听力最有效的手术方法。鼓室成形术、随访