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目的:分析鼓室硬化患者手术前后骨导听力的变化,并探讨其可能的原因。方法:回顾性分析30例确诊为鼓室硬化患者的病例资料。结果:30例患者中,患侧术前骨导平均阈值为(21.06±8.88)dBHL,健耳术前骨导平均阈值为(16.78±8.97)dBHL,术前患耳骨导听阈的提高具有统计学意义(t=3.072,P<0.01)。鼓室硬化患者骨导平均阈值、气导平均阈值和骨气导间距术后均较术前降低,差异均有统计学意义。术前骨导阈值在2 000Hz处最高,为(25.17±10.95)dB。术后骨导阈值在500、1 000、2 000 Hz 3个频率上的下降具有统计学意义(P<0.05或P<0.01)。鼓室硬化患者行乳突切开+鼓室成形术,术后骨导听阈较仅行鼓室成形术者有显著改善(P<0.05)。结论:鼓室硬化可导致患者骨导阈值升高;清除鼓室硬化灶的同时处理鼓窦及乳突的病灶以及重建传声结构,不仅可改善气导听力和缩小骨气导间距,而且还能使术后骨导听力显著改善。
Objective: To analyze the changes of bone conduction hearing before and after tympanosclerosis patients and to explore its possible causes. Methods: A retrospective analysis of 30 cases of patients diagnosed as tympanosclerosis case data. Results: The average preoperative bone conduction threshold was (21.06 ± 8.88) dBHL in preoperative patients and 16.78 ± 8.97 dBHL in healthy ears. The increase of preoperative bone conduction hearing index was statistically significant Significance (t = 3.072, P <0.01). In patients with tympanosclerosis, the mean value of the average value of the bone conduction, the mean value of the airway conductance, and the distance between the two groups were all significantly lower than those before operation. The differences were statistically significant. The preoperative bone conduction threshold was the highest at 2 000 Hz, which was (25.17 ± 10.95) dB. Postoperative bone conduction threshold at 500,1 000,2 000 Hz three frequency reduction was statistically significant (P <0.05 or P <0.01). Tympanotomy and tympanoplasty were performed in patients with tympanosclerosis, and postoperatively, the bone conduction threshold was significantly improved (P <0.05). Conclusions: Tympanosclerosis may lead to an increase in the bone conduction threshold in patients. The removal of tympanosclerosis, simultaneous treatment of the lesions of the sinuses and the mastoid, and the reconstruction of the transmission structure not only improve air conduction and reduce the distance between the tracheoespheres, Posterior bone conduction significantly improved.