虽然各型中耳炎的听力损失被传统地描述为传导性的,但过去10年间已注意到很多中耳渗液病例(主要是儿童)的骨导是降低的。作者们引证Paparella的研究,认为慢性中耳炎骨传导损失的机制似乎是“化学性污染”,即毒素通过圆窗膜被吸收。组织学证据表明,圆窗的变化在化脓性中耳炎较非化脓性中耳炎更为显著。这些改变,尤其是急性化脓性病例中的底转毛细胞损害,可暂时或永久地使耳对将来的损伤如噪声性聋和老年聋更为易感。这种理论似可解释为何在某些病人中观察到骨导下降而在另一些则否,尽管病因明显相同。本文目的是进一步研究慢性中耳炎的诊断性和预后性意义,特别着重估价感觉神经性聋成 Although hearing loss of various types of otitis media has traditionally been described as conductive, it has been noted in the past decade that the bone conduction of many cases of middle ear effusion (mainly children) is reduced. The authors cite Paparella’s study suggesting that the mechanism of bone conduction loss in chronic otitis media appears to be “chemically contaminated,” meaning that the toxin is absorbed through the round window membrane. Histological evidence suggests that the change in round window is more pronounced in suppurative otitis media than in non-suppurative otitis media. These changes, especially in acute suppurative cases of dorsal hair cell damage, can temporarily or permanently make the ear more susceptible to future injuries such as noise-induced hearing loss and senile deafness. This theory may seem to explain why in some patients bone degeneration was observed, whereas in others, the cause was clearly the same. The purpose of this paper is to further investigate the diagnostic and prognostic significance of chronic otitis media, with particular emphasis on the evaluation of sensory nerve deafness