耳硬化症患者镫骨底板造孔术后高频感音神经性听力下降原因分析

The Analysis of High Frequency Sensorineural Hearing Loss Caused by Piston Technique of Stapes Surgery in Patient with Otosclerosis

李湘辉;张志钢;郑亿庆;梁象逢;陈玲;邱泽恒;

1:中山大学附属第二医院耳鼻咽喉科

摘要
目的探讨耳硬化症患者镫骨底板切除术后高频感音神经性听力下降的原因。方法回顾性总结中山大学附属第二医院2004年2月~2009年2月行镫骨底板切除术的30例(49耳)耳硬化症患者的临床资料,比较所有患者术前2天、术后1、3、6个月纯音测听结果,并分析年龄、术后耳鸣对听力的影响。结果术后1个月气导8000Hz平均听阈比术前提高了约8dB,骨导4000Hz平均听阈提高约10dB(P<0.01)。≥40岁组术后高频平均听阈比<40岁组明显提高(P<0.01)。术后1个月有25耳(51%)出现耳鸣,其中约80%患者术后3个月耳鸣消失,听力明显改善。结论耳硬化症患者行镫骨底板切除术后大部分患者可出现暂时性高频感音神经性听力下降,术后3个月听力明显改善,≥40岁患者高频听力受损明显。其原因可能为手术过程中对镫骨底板的过度非生理性振动,通过耳蜗内淋巴液导致靠近底板的外毛细胞功能受到影响,从而使高频听力暂时下降。
关键词
耳硬化症;镫骨底板切除术;高频听力下降;耳鸣;感音神经性
基金项目(Foundation):
作者
李湘辉;张志钢;郑亿庆;梁象逢;陈玲;邱泽恒;
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