鼓膜张肌腱对鼓室成形术后听力重建效果的影响

The Effects of Tensor Tympani Muscle on the Hearing Reconstruction Outcome

刘林;秦兆冰;李素娟;张帆;齐思涵;

1:郑州大学第一附属医院耳鼻咽喉科

摘要
目的分析鼓膜张肌腱的完整性对鼓室成形术后鼓膜形态及听力重建效果的影响,为术中鼓膜张肌腱的处理提供参考。方法回顾性分析145例(耳)慢性化脓性中耳炎患者的临床资料,按鼓膜张肌腱完整与否及植入听骨类型的不同进行分组,其中鼓膜张肌腱完整组80例[植入部分听骨赝复物(PORP)45例,全听骨赝复物(TORP)35例],鼓膜张肌腱离断组65例(植入PORP 34例,TORP 31例),观察并比较各组患者术后1、3个月时鼓膜形态及术后6个月时听力情况。结果术后1个月时,两组鼓膜形态无明显差别;术后3个月时,鼓膜张肌腱完整组鼓膜形态接近正常者的比例(81.25%,65/80)明显高于离断组(52.31%,34/65)。术后6个月时鼓膜张肌腱完整组(植入PORP)0.54kHz气导平均听阈(27.48±10.02dB HL)和气骨导差(13.57±6.36dB)均好于鼓膜张肌腱离断组(分别为32.36±9.34dB HL和25.73±7.44dB)。植入TORP的鼓膜张肌腱完整组0.54kHz气导平均听阈(27.48±10.02dB HL)和气骨导差(13.57±6.36dB)均好于鼓膜张肌腱离断组(分别为32.36±9.34dB HL和25.73±7.44dB)。植入TORP的鼓膜张肌腱完整组0.54kHz气导平均听阈(28.76±7.14dB HL)和气骨导差(21.02±5.48dB)也均好于鼓膜张肌腱断离组(分别为39.93±5.12dB HL和31.41±6.25dB)。结论鼓膜张肌腱的完整有利于维持鼓室成形术后鼓膜的正常位置和形态,听力重建术中保留鼓膜张肌腱对术后听力恢复有明显改善作用。
关键词
鼓膜张肌腱;鼓膜形态;耳内镜;纯音测听
基金项目(Foundation):
作者
刘林;秦兆冰;李素娟;张帆;齐思涵;
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