de Bruijn A J, Tange R A, Dreschler W A
Department of Otorhinolaryngology-Head and Neck Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
Otolaryngol Head Neck Surg. 2001 Jan;124(1):76-83. doi: 10.1067/mhn.2001.111601.
The Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery proposed guidelines to provide more uniformity in reporting hearing results after middle ear surgery. One of the proposals was to include the hearing thresholds at 0.5, 1, 2, and 3 kHz in a 4-frequency pure-tone average (PTA) and to use post-operative bone-conduction (BC) levels rather than preoperative BC levels in describing postoperative air-bone gaps (ABGs). The hearing results of 451 stapes operations were evaluated to analyze to what extent the choice of different audiologic criteria affects success rates. It appeared that choice of PTA significantly affects postoperative gain in air-conduction thresholds and ABG levels. If one takes the improvements in speech-reception thresholds as the gold standard, the gain in air-conduction correlates best with a gain in speech-reception threshold if a higher frequency, such as 3 or 4 kHz, is included in a 4-frequency PTA. Also, choice of preoperative or postoperative BC in computing postoperative ABGs had a significant effect on the mean postoperative ABG levels, showing more favorable results with the use of preoperative BC thresholds.
美国耳鼻咽喉-头颈外科学会听力与平衡委员会提出了指导方针，以便在报告中耳手术后的听力结果时提供更多的一致性。其中一项提议是，在4频率纯音平均（PTA）中纳入0.5、1、2和3千赫兹的听力阈值，并在描述术后气骨导差（ABG）时使用术后骨导（BC）水平而非术前BC水平。对451例镫骨手术的听力结果进行了评估，以分析不同听力标准的选择在多大程度上影响成功率。结果显示，PTA的选择显著影响气导阈值和ABG水平的术后增益。如果将言语接受阈值的改善作为金标准，那么在4频率PTA中纳入较高频率（如3或4千赫兹）时，气导增益与言语接受阈值增益的相关性最佳。此外，在计算术后ABG时选择术前或术后BC对术后ABG平均水平有显著影响，使用术前BC阈值显示出更有利的结果。
