中耳手术术中听力监测和术后听力恢复相关性研究

冯天赐;杨海弟;郑亿庆;熊浩;陈越勃;黄夏茵;

1:中山大学孙逸仙纪念医院耳鼻咽喉头颈外科

摘要

目的探讨中耳手术术中听力监测与患者术前气导纯音听阈及术后听力预估的相关性。方法 42例(42耳)中耳手术患者(男19例,女23例,年龄5～70岁,平均36.63±15.57岁),其中中耳胆脂瘤8例,耳硬化症3例,鼓室硬化4例,分泌性中耳炎17例,慢性化脓性中耳炎10例;在全麻后,于手术前、手术结束即刻对所有患者进行声场Chirp声自动听性脑干反应(AABR)监测,所得阈值分别与患者术前气导纯音听阈和术后3个月纯音听阈比较。结果 42例(42耳)中,仅24例完成了术后3个月的纯音听阈检查,这24例(24耳)患者术前、术中手术结束即刻声场AABR监测阈值分别为58.75±9.70、39.38±12.80dB HL,术前500、1 000、2 000、4 000Hz纯音气导平均听阈分别为51.04±14.59、48.12±15.59、43.33±14.87、50.00±19.33dB HL,500～4 000Hz气导平均听阈(PTA)为48.13±13.79dB HL;术后3个月分别为34.38±18.20、32.70±18.47、33.75±15.12、40.63±16.44dB HL,,500～4 000Hz气导PTA为35.36±14.90dB HL差异均有统计学意义(P<0.05)。术前AABR反应阈与术前气导PTA具有相关性,术中手术结束即刻AABR反应阈与术后3个月500～4 000Hz气导PTA具有良好的相关性。结论中耳手术中声场Chirp声AABR监测能有效预估患者术后听力。

关键词

术中听力监测;中耳手术;自动听性脑干反应(AABR)

基金项目(Foundation):

广东省科技计划项目(2013B022000051);; 广东省自然自由申请项目(2015A030313084)

作者

冯天赐;杨海弟;郑亿庆;熊浩;陈越勃;黄夏茵;

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冯天赐杨海弟郑亿庆熊浩陈越勃黄夏茵