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鼓室硬化类型与手术疗效(附40例临床分析)

Surgical outcomes of different types of tympanosclerosis(40 cases report)

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【作者】 林隽沈帆李瑞玉叶青

【Author】 LIN Jun,SHEN Fan,LI Rui-yu,YE Qing (Department of Otolaryngology,the Provincial Hospital of Fujian Medical University,Fuzhou 350001,China)

【机构】 福建医科大学省立临床医学院福建省立医院耳鼻喉科

【摘要】 目的探讨硬化灶累及中耳部位与术前听力损失类型的关系、不同手术方式治疗鼓室硬化症的效果。方法回顾性分析40例鼓室硬化患者术前资料,术中病灶记录,评估术后听力改善水平。结果传导性耳聋的病例中最常见病灶侵及上鼓室、锤砧关节周围,而混合性耳聋的病例中病灶累及鼓岬的概率明显高于传导性耳聋的病例。术后气骨导间距小于20dB18耳,成功率40%,Ⅰ型鼓室硬化症术后听力改善最显著(P<0.05)。结论听力损失的性质与硬化灶的范围及累及中耳的部位直接相关。手术处理是治疗鼓室硬化症的主要手段,手术方式则根据病变累及的范围和程度决定。

【Abstract】 Objective To study the relationship between the type of preoperative hearing loss and the site of tympanosclerosis,and analyze the effect of our surgical protocol for patients. Methods The preoperative features,sclerosis focus detected during surgery and hearing levels after surgery on tympanosclerosis were retrospectively summed up for 40 patients in our hospital from October 2005 to December 2009. Results While attic and the incudostapedial joint involvement are most frequently seen in conductivetype hearing loss,mixed type hearing loss isolated promontorium and involvement of the incudostapedial joint and around stapes are not seen.Post-op outcome was found to be 40% in the patients with an air-bone gap between 0-20 dB.The best hearing result belonged to type 1 patients. Cases in which the stapes footplate was fixated had the worst result in terms of hearing. Conclusion There is a direct relationship between the type of preoperative hearing loss and the site of tympanosclerosis. Surgery is the main method for tympanosclerosis.The operation should be adapted to different areas and degrees of the sclerosis focus.

【关键词】 鼓室硬化鼓室成形术效果
【Key words】 TympanosclerosisTympanoplastyResult
  • 【文献出处】 山东大学耳鼻喉眼学报 ,Journal of Otolaryngology and Ophthalmology of Shandong University , 编辑部邮箱 ,2010年06期
  • 【分类号】R764.21
  • 【被引频次】1
  • 【下载频次】77
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