Katsura Hirokazu, Tsuji Kojiro, Muto Toshihiko, Terada Tomonori, Saeki Nobuo, Sakagami Masafumi
Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya.
Nihon Jibiinkoka Gakkai Kaiho. 2004 Jan;107(1):12-7. doi: 10.3950/jibiinkoka.107.12.
The management of only hearing ears remains controversial because of the risk of postoperative hearing deterioration. We reviewed 12 cases of hearing ears alone operated on at the Hyogo College of Medicine Department of Otolaryngology from 1999 to 2002. All ears were dry at the final examination. Postoperative hearing results were evaluated based on the guideline of the Japan Otological Society (2000). An air bone gap within 15 dB was found in 9 cases (75%), hearing gain exceeding 15 dB was found in 6 cases (50%), the hearing level was within 30 dB in 4 cases (33.3%), and total successful cases numbered 10 (83.3%). Eight patients wore hearing aids before surgery, and 4 patients (50%) did not need them after the surgery. We suggest that tympanoplasty by skillful surgeons should be done to obtain a dry ear, to avoid a progressive hearing loss, to preserve or improve hearing, and to improve the quality of life. We also suggest that handling of ossicles should minimized in chronic otitis media and cholesteatoma.
由于存在术后听力恶化的风险，仅对单耳有听力的情况进行处理仍存在争议。我们回顾了1999年至2002年期间在兵库医科大学耳鼻咽喉科接受手术的12例单耳有听力的病例。在最后一次检查时所有耳朵均已干耳。术后听力结果根据日本耳科学会（2000年）的指南进行评估。9例（75%）气骨导差在15dB以内，6例（50%）听力增益超过15dB，4例（33.3%）听力水平在30dB以内，总成功病例数为10例（83.3%）。8例患者术前佩戴助听器，术后4例（50%）不再需要佩戴。我们建议应由技术熟练的外科医生进行鼓室成形术，以实现干耳、避免进行性听力损失、保留或改善听力并提高生活质量。我们还建议在慢性中耳炎和胆脂瘤中应尽量减少听小骨的处理。
