鼓膜张肌腱对鼓室成形术后听力重建效果的影响

发布时间：2018-02-12 03:04

本文关键词： 鼓膜张肌腱鼓膜形态耳内镜纯音测听　出处：《听力学及言语疾病杂志》2014年06期 　论文类型：期刊论文

【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)0.5~4kHz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0.5~4kHz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。
[Abstract]:Objective to analyze the effect of the integrity of tensor tendon of tympanic membrane on the shape of tympanic membrane and the effect of hearing reconstruction after tympanoplasty. Methods the clinical data of 145 cases (ears) with chronic suppurative otitis media were analyzed retrospectively. Among them, 80 cases of intact tensor tendon of tympanic membrane [45 cases of PORPV implanted with partial ossicular prosthesis], There were 35 cases of total ossicular ossicular prosthesis and 65 cases of tensor tensor tendon amputation group (34 cases of PORP were implanted with TORP). The morphology of tympanic membrane was observed and compared at 1 and 3 months after operation and the hearing at 6 months after operation. Results 1 month after operation, 1 month after operation, 1 month after operation, 1 month after operation, 1 month after operation, 31 cases of tympanic membrane were observed and compared. There was no significant difference in the shape of tympanic membrane between the two groups. The ratio of the tympanic membrane in the intact tympanic tensor tendon group was 81.25% and 65 / 80 was significantly higher than that in the amputated tensor tensor tendon group (52.31% 34 / 65). At 6 months after operation, the complete tympanic tensor tendon group (mean PORP)0.5~4kHz air-conduction threshold 27.48 卤10.02 dB HL) and the air-bone conductance difference 13.57 卤6.36 dB were better than those in the intact tympanic tensor tendon group (13.57 卤6.36 dB). The mean air conduction threshold of 0.5 kHz in the intact tympanic tensor tendon group was 28.76 卤7.14 dB HLand the air-bone conductance difference was 21.02 卤5.48 dB in the TORP implanted tensor tensor tendon group (32.36 卤9.34 dB HL and 25.73 卤7.44 dB HL, respectively). Conclusion the integrity of the tensor tendon of the tympanic membrane is beneficial to the tensor tendon of the tympanic membrane (39.93 卤5.12 dB HL and 31.41 卤6.25 dB). To maintain the normal position and shape of tympanic membrane after tympanoplasty. The preservation of tensor tendon in tympanic membrane during the reconstruction of hearing can improve the hearing recovery after operation.
【作者单位】：郑州大学第一附属医院耳鼻咽喉科;
【分类号】：R764.9

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