Habib M A, Huq M Z, Aktaruzzaman M, Alam M S, Joarder A H, Hussain M A
Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, Bangladesh.
Mymensingh Med J. 2011 Jul;20(3):478-83.
This cross sectional study was done to find out the level of hearing improvement in Type-I tympanoplasty with cortical mastoidectomy in tubotympanic chronic otitis media. Data were analyzed from 60 patients with audiometric studies with a minimum of 6 months follow up. Patients who under went tympanoplasty alone were kept in Group I, and who under went tympanoplasty with cortical mastoidectomy were kept in Group II. All patients prior to tympanoplasty were examined thoroughly after taking detailed history. On otoscopy, site and size of the tympanic membrane perforation, condition of the rest of the tympanic membrane, condition of the middle ear mucosa and the ossicles were noted. Tuning fork test, test for facial nerve integrity and fistulae test were performed. Hearing level was assessed by pure tone audiometry with masking. X-ray mastoid and X-ray paranasal sinuses were done to exclude local pathology. Surgical approaches were mostly post-auricular and in few cases it was per-meatal in Group I patient. Audiometric evaluation performed according to the International Organization for Standardization (ISO) standard. Hearing threshold measured at 250, 500, 1000, and 2000 Hz. Hearing improvement was assessed by closure of the air bone gap. Mean closure of air bone gap in Group I was 9.38 dB and in Group II it was 20.61 dB which was statistically significant (p<0.001). Improvement of hearing level was more in patient who underwent tympanoplasty with cortical mastoidectomy than those patients on whom only tympanoplasty was performed. Hearing gain is more in Type-1 tympanoplasty combining with Cortical Mastoidectomy than in Type-1 tympanoplasty alone in the patient's of tubotympanic otitis media.
本横断面研究旨在了解在鼓室乳突型慢性中耳炎患者中，行I型鼓室成形术联合皮质骨乳突切除术的听力改善水平。对60例接受听力测定研究且随访至少6个月的患者数据进行分析。仅接受鼓室成形术的患者归入第一组，接受鼓室成形术联合皮质骨乳突切除术的患者归入第二组。所有患者在鼓室成形术前均在详细询问病史后进行全面检查。耳镜检查时，记录鼓膜穿孔的部位和大小、鼓膜其余部分的状况、中耳黏膜和听小骨的状况。进行音叉试验、面神经完整性测试和瘘管试验。通过纯音听力计掩蔽法评估听力水平。进行X线乳突和X线鼻旁窦检查以排除局部病变。第一组患者的手术入路大多为耳后，少数情况下为经耳道。听力评估按照国际标准化组织（ISO）标准进行。在250、5阗、1000和2000赫兹处测量听力阈值。通过气骨导间距的缩小评估听力改善情况。第一组气骨导间距的平均缩小值为9.38分贝，第二组为20.61分贝，具有统计学意义（p<0.001）。接受鼓室成形术联合皮质骨乳突切除术的患者听力水平的改善比仅接受鼓室成形术的患者更大。在鼓室乳突型中耳炎患者中，I型鼓室成形术联合皮质骨乳突切除术比单纯I型鼓室成形术的听力增益更大。
