中耳胆脂瘤患者的听骨链病变特点及其危险因素分析

彭洪;谭君武;向二英;

1:湖北民族学院附属民大医院耳鼻咽喉头颈外科

2:湖北民族学院附属民大医院小儿内科

摘要
目的探讨中耳胆脂瘤患者的听骨链病变特点及其相关危险因素。方法回顾性分析249例(288耳)中耳胆脂瘤患者的听骨链状态与鼓膜穿孔类型、术前是否干耳、气导平均听阈值、气骨导差值、乳突气化类型、耳源性并发症之间的相关性。结果 288耳中听骨链完整组121耳,听骨链中断组167耳,两组言语频率平均气导听阈及气骨导差分别为45.10±14.24dB HL、26.72±9.97dB和53.71±16.99dB HL、33.33±11.77dB;听骨链完整组平均气导阈值、气骨导差值明显低于听骨链中断组(P<0.05);听骨链中断的相关危险因素Logistic回归分析显示,鼓膜穿孔、耳漏和并发症均是听骨链中断的危险因素,OR值分别为2.181、3.401、1.731(P<0.05),有统计学意义。鼓膜松弛部穿孔患者听骨链中断的概率是紧张部穿孔患者的2.181倍;术前持续流脓者听骨链中断的概率是术前干耳患者的3.401倍;出现并发症患者的听骨链中断发生率较高,是无并发症患者的1.731倍。结论听骨链中断的中耳胆脂瘤患者的气导阈值和气骨导差值明显增加;鼓膜松弛部穿孔、术前持续流脓及出现耳源性并发症患者的听骨链中断的概率明显增加;听骨链状况与鼓膜穿孔类型、术前是否干耳、乳突类型和耳源性并发症耳具有明显相关性。
关键词
中耳胆脂瘤;听骨链;纯音听阈
基金项目(Foundation):
湖北省卫生厅科研基金项目(JX2C42)
作者
彭洪;谭君武;向二英;
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彭洪谭君武向二英