Hyde N C, Bailey B M
The Maxillofacial Unit, University College Hospital, London, UK.
Br J Oral Maxillofac Surg. 2000 Aug;38(4):283-8. doi: 10.1054/bjom.1999.0286.
Little has been reported about the effect on auditory tube function of ablative surgery for maxillary neoplasms. Operations on the muscles of the soft palate may cause conductive hearing loss by impairing the opening of the auditory tube, which results in a middle ear effusion. Sensorineural hearing loss may also follow adjuvant radiotherapy. In this retrospective study we aimed to assess hearing status in patients who had undergone maxillary surgery for neoplastic disease between 1987 and 1997. Data recorded included personal details, site and size of lesion, treatment, and histology. Thirty-eight patients were identified, of whom 26 had survived and were contacted. Seventeen of the 26 had had part of the soft palate excised. All patients underwent tympanometry and had a pure tone audiogram. Audiograms showed an air-bone gap of > 10 dB in the ear on the side of the operation in 11 of those 17 patients. All 17 patients who had had soft palate resections had evidence of auditory tube insufficiency on tympanometry. Seven of the nine patients who had had radiotherapy had substantial sensorineural hearing loss. We conclude that conductive hearing loss is dependent on the site of resection; tympanometry is a sensitive test of middle ear function; sensorineural hearing loss may often follow radiotherapy; and audiological assessment is essential both before and after operation in patients having maxillary resections.
关于上颌肿瘤切除手术对咽鼓管功能的影响，相关报道较少。软腭肌肉手术可能会因妨碍咽鼓管开放而导致传导性听力损失，进而引起中耳积液。辅助放疗后也可能出现感音神经性听力损失。在这项回顾性研究中，我们旨在评估1987年至1997年间因肿瘤疾病接受上颌手术的患者的听力状况。记录的数据包括个人详细信息、病变部位和大小、治疗方法以及组织学。共确定了38例患者，其中26例存活并取得了联系。这26例患者中有17例切除了部分软腭。所有患者均接受了鼓室图检查并进行了纯音听力图测试。在这17例患者中，有11例患者手术侧耳朵的听力图显示气骨导差大于10分贝。所有17例进行了软腭切除的患者在鼓室图检查中均有咽鼓管功能不全的证据。接受放疗的9例患者中有7例出现了明显的感音神经性听力损失。我们得出结论，传导性听力损失取决于切除部位；鼓室图检查是中耳功能的敏感测试；放疗后常可能出现感音神经性听力损失；对于接受上颌切除术的患者，术前和术后进行听力评估至关重要。
