鼓室成形术后听力的变化及相关影响因素分析

发布时间：2018-03-24 09:54

本文选题：慢性化脓性中耳炎　切入点：鼓室成形术　出处：《新疆医科大学》2012年硕士论文

【摘要】：目的：探讨应用自体耳屏软骨鼓膜修补鼓并鼓室成形术治疗慢性化脓性中耳炎(CSOM)患者的手术疗效。方法：回顾性分析我院2010年1月之2011年12月49例鼓膜穿孔慢性化脓性中耳炎患者采用对用耳屏软骨修补鼓膜、同时行鼓室成形术，，随访1年以上，复查纯音测听比较术前术后听力的变化趋势，并记录患者日常生活中主观听力的改善。结果：49例中耳炎中耳炎患者中，手术后1个月后修补的鼓膜成活.术后随访1年余,除1耳鼓膜穿孔外其余耳均愈合,纯音测听示，气导平均阈值行中耳探查+鼓室成性术后提高20dB以内的患者（18耳）69.3%，行此手术方式患耳共有26耳占53.1%；行乳突根治+鼓室成形术+听骨链重建术患耳23例，占46.9%，术后气导平均阈值提高30-40dB以内共有13耳，占56.5%，提高20dB、30dB各有3耳（26%）；术后主观听力改善者37耳，无变化6耳，较术前变差6耳，术后气导提高30dB以内时，77.4%患者（27耳）有明显主观听力改善。结论：行鼓室成形术的中耳炎患者进行术前术后比较纯音测听，并结合患者主观听力，可判断鼓室成形术后听力变化情况；用自体耳屏软骨修补鼓膜的鼓室成形术后听力改善明显,使用的软骨移植易成活，鼓膜支撑方面作用好,因而术后可有效的防止修补鼓膜的回缩，并听骨的粘连，提高鼓室成形术的远期效果有一定的作用。
[Abstract]:Objective: to investigate the effect of tympanic membrane repair and tympanoplasty on chronic suppurative otitis media with tympanic membrane repair and tympanoplasty. Methods: 49 cases of chronic tympanic membrane perforation in our hospital from January 2010 to December 2011 were analyzed retrospectively. In patients with suppurative otitis media, the tympanic membrane was repaired with tragular cartilage. At the same time, tympanoplasty was performed, followed up for more than one year. The change trend of hearing was compared with pure tone audiometry before and after operation, and the improvement of subjective hearing in daily life of the patients was recorded. Results in 49 cases of otitis media patients with otitis media, The tympanic membrane repaired one month after operation survived. All ears healed except for 1 perforation of tympanic membrane after operation for more than one year. The mean threshold of air conduction was used to improve the tympanoplasty within 20dB after middle ear exploration in 18 ears (69.3 ears), 26 ears (53.1 ears) were treated with this operation, and 23 cases were treated with mastoid radical tympanoplasty and ossicular chain reconstruction. After operation, there were 13 ears (56.5%) within 30-40dB, 3 ears (26 ears) in 30 dB of 20 dB improvement, 37 ears with improvement of subjective hearing after operation, 6 ears with no change, 6 ears worse than those before operation, 3 ears with 30 dB increase of 20 dB, 6 ears with no change after operation, 3 ears with 30 dB increase of 20 dB, 6 ears with no change after operation. There was significant improvement in subjective hearing in 77.4% patients (77.4%). Conclusion: tympanoplasty was performed in patients with tympanoplasty with pure tone audiometry before and after operation, and combined with subjective hearing. The hearing changes after tympanoplasty can be judged. After tympanoplasty, the hearing of tympanic membrane repaired with autogenous tympanic cartilage can be improved obviously, the cartilage grafts used are easy to survive, and the tympanic membrane can be supported well. So it can effectively prevent the repair of tympanic membrane and ossicular adhesion and improve the long-term effect of tympanoplasty.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R764

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