慢性化脓性中耳炎鼓膜穿孔特征与听力损失的相关性研究

A Study of the Correlation between the Characteristics of Tympanic Membrane Perforation and Hearing Loss in Chronic Suppurative Otitis Media

柴静;边盼盼;徐百成;郭玉芬

1:兰州大学第二医院耳鼻咽喉头颈外科

摘要
目的 探讨慢性化脓性中耳炎鼓膜穿孔特征与听力损失的相关性。方法 回顾性分析2022年7月~2023年7月于兰州大学第二医院耳鼻咽喉头颈外科确诊为慢性化脓性中耳炎并行Ⅰ型鼓室成形术治疗的80例患者(104耳)的纤维耳内镜图像及完整的听力学资料。采用ImageJ图像软件测量鼓膜穿孔面积,以穿孔边界面积占完整鼓膜边界面积的百分比(RAp值)为鼓膜穿孔相对面积。分析不同面积鼓膜穿孔、穿孔涉及象限、穿孔边缘是否钙化以及穿孔范围是否累及锤骨柄与气骨导差(ABG)的关系。结果 慢性化脓性中耳炎鼓膜穿孔患者的鼓膜穿孔面积与平均气骨导差之间呈显著正相关关系(R~2=0.141,P<0.000 1),相对穿孔面积越大者ABG越大;穿孔累及锤骨柄的患者较未累及锤骨柄的患者气骨导差更大(P<0.05);鼓膜穿孔边缘钙化情况和穿孔位置对听力损失的影响很小,几乎可以忽略不计。结论 鼓膜穿孔引起的传导性听力损失与穿孔大小和穿孔是否累及锤骨柄有关,穿孔相对面积越大及穿孔累及锤骨柄患者的传导性听力损失往往更重。
关键词
慢性化脓性中耳炎;鼓膜穿孔;传导性听力损失;鼓膜钙化;锤骨柄
基金项目(Foundation):
国家自然科学基金地区项目(81570926);国家自然科学基金地区项目(31960132);国家自然科学基金地区项目(32160149);; 甘肃省自然科学基金(21JR7RA429)
作者
柴静;边盼盼;徐百成;郭玉芬
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