Strömbäck Karin, Köbler Susanne, Rask-Andersen Helge
Department of Otolaryngology, Uppsala University Hospital, Uppsala, Sweden.
Acta Otolaryngol. 2012 Sep;132(9):944-50. doi: 10.3109/00016489.2012.677859. Epub 2012 Jun 12.
Our results indicate that a pre-existing sensorineural hearing loss (SNHL) is not a potential risk factor for further hearing loss in stapes surgery.
The study evaluated whether pre-existing SNHL in otosclerosis constitutes a risk factor for further hearing loss in stapedotomy.
Preoperative and postoperative audiometric evaluation including air (AC) and bone conduction (BC) hearing levels were assessed together with collection of surgical records from 338 consecutively operated cases for primary otosclerosis using a database. Patients were operated by the same surgeon between 2000 and 2006. In all, 291 patients were operated on 1 side and 47 patients were operated on both sides. Ages ranged from 16 to 76 years. Stapedotomy was performed in all cases except five (stapedectomy). Cases were separated into four different groups based on preoperative AC hearing levels at 4, 6, and 8 kHz: group I, <30 dB HL; group II, 30-50 dB HL; group III, 51-70 dB HL; group IV, >70 dB HL).
Hearing deterioration at 4, 6, and 8 kHz (>10 dB) was observed in 6.5% of all cases. Patients with normal preoperative hearing were found to be more prone to further SNHL 4, 6, and 8 kHz (range 13-25 dB) at surgery, while patients in group IV, with preoperative SNHL impairment, remained unaffected.
我们的结果表明，术前存在的感音神经性听力损失（SNHL）并非镫骨手术中进一步听力损失的潜在风险因素。
本研究评估耳硬化症患者术前存在的SNHL是否为镫骨切除术进一步听力损失的风险因素。
通过数据库收集338例连续接受原发性耳硬化症手术患者的术前和术后听力测试评估结果，包括气导（AC）和骨导（BC）听力水平，并收集手术记录。患者于2000年至2006年间由同一位外科医生进行手术。其中，291例患者接受单侧手术，47例患者接受双侧手术。年龄范围为16至76岁。除5例（镫骨切除术）外，所有病例均行镫骨切开术。根据术前4、6和8kHz的AC听力水平将病例分为四个不同组：I组，<30dB HL；II组，30 - 50dB HL；III组，51 - 70dB HL；IV组，>70dB HL）。
所有病例中，4、6和8kHz处听力恶化（>10dB）的发生率为6.5%。术前听力正常的患者在手术时更易在4、6和8kHz处出现进一步的SNHL（范围为13 - 25dB），而术前存在SNHL损伤的IV组患者未受影响。
