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为探讨慢性化脓性中耳炎影响内耳听觉功能的机理。统计了200例、240耳慢性化脓性中耳炎(COM)患者的病史、纯音测听、乳突拍片和CT扫描的结果;并对中耳病变与耳聋性质及程度的关系,进行分析。制备化脓性中耳炎豚鼠12只、15耳,在光镜及电镜下观察耳蜗Corti′s器外毛细胞的病理变化。结果:本组患者合并感音性聋(SNHL)107耳,占44.6%;病史5年以内及5年以上SNHL合并率分别为28.5%和63.6%,差异有高度显著性(P<0.01);中耳病变Ⅰ型及Ⅱ~Ⅲ型COM患者SNHL合并率为27.9%和85.7%,差异有高度显著性(P<0.01);观察COM豚鼠耳蜗Corti′s器外毛细胞有病理损害。病史越长,中耳病变越重,耳蜗外毛细胞损害越重,SNHL合并率越高。
To investigate the mechanism of chronic suppurative otitis media affecting the auditory function of the inner ear. The clinical data of 200 patients with chronic suppurative otitis media (COM) in 240 ears were analyzed. The results of pure tone audiometry, mammography and CT scan were analyzed. The relationship between the nature and degree of middle ear lesion and deafness was also analyzed. Preparation of purulent otitis media guinea pigs 12, 15 ears, under light and electron microscopy Cochlear Corti’s external hair cells in the pathological changes. Results: There were 107 ears with sensory hearing loss (SNHL), accounting for 44.6%. The combined rates of SNHL within 5 years and over 5 years were 28.5% and 63.6% respectively, the difference was highly significant (P <0.01). The incidence of SNHL complicated by middle ear disease type Ⅰ and type Ⅱ ~ Ⅲ was 27.9% and 85.7%, respectively. The difference was highly significant (P0.01) Cochlear Corti’s external hair cells have pathological damage. The longer the history, the heavier the middle ear lesions, the more severe damage to the outer hair cells of the cochlea, the higher the rate of SNHL merger.