School of Medicine University of Belgrade, Serbia.
Otol Neurotol. 2012 Aug;33(6):934-40. doi: 10.1097/MAO.0b013e318259b885.
To determine predicting value of otitis type, age, gender, ear suppuration, disease duration, mucosal changes, cholesteatoma spreading, labyrinthine fistula, size, localization of tympanic membrane perforation, type and stage of its retraction and ossicular chain disruption with sensorineural hearing loss in patients with tubotympanic otitis, cholesteatoma, and tympanic membrane retractions.
Retrospective case review study.
Tertiary referral center.
Approximately 264 adult patients with unilateral chronic ear disease, 60 adult patients with tympanic membrane retractions, 78 with cholesteatoma, and 126 with tubotympanic otitis.
Otomicroscopy, pure tone audiometry, impedancemetry were carried out preoperatively. Wall up, wall down tympanoplasty, or two-stage surgery was applied depending on pathology.
Bone conduction thresholds for 512 to 4,096 Hz.
Mean values of bone conduction thresholds for frequencies 512 to 4,096 Hz were significantly higher in otitis groups than in healthy ears (p = 0.000), without differences between the groups. Ossicular disruption correlated with sensorineural hearing loss in cholesteatoma and tubotympanic otitis for all frequencies; long incus process destruction in tubotympanic ears showed strong negative correlation with sensorineural hearing loss for 512 to 2,048 Hz (linear regression coefficient, intercept was -2.84, -2.48, and -2.41; p = 0.0024, 0.0207, and 0.0076, respectively). Perforation size correlated with sensorineural hearing loss for 512 to 2,048 Hz in tubotympanic otitis (Log regression p = 0.0008, 0.0252, and 0.0267; odds ratio, 1.13, 1.11, and 1.06). Atelectasis correlated with sensorineural hearing loss for 4,096 Hz (p = 0.022).
Predictors for sensorineural hearing loss in chronic otitis are otitis itself, age, ossicular disruption, especially of long incus process, extensive labyrinthine fistula, perforation size, and type of retraction.
确定中耳炎类型、年龄、性别、耳流脓、病程、黏膜变化、胆脂瘤扩散、迷路瘘管、大小、鼓膜穿孔位置、鼓膜内陷及其回缩和听骨链破坏的类型和阶段与鼓室-乳突炎、胆脂瘤和鼓膜内陷患者的感音神经性听力损失之间的预测价值。
回顾性病例研究。
三级转诊中心。
约 264 名单侧慢性耳部疾病的成年患者，60 名鼓膜内陷的成年患者，78 名胆脂瘤患者和 126 名鼓室-乳突炎患者。
术前进行耳镜检查、纯音测听和阻抗测量。根据病理情况，应用鼓室成形术、鼓室成形术加乳突切除术或二期手术。
512 至 4096 Hz 的骨导阈值。
512 至 4096 Hz 频率的骨导阈值平均值在中耳炎组明显高于健康耳（p=0.000），但组间无差异。在胆脂瘤和鼓室-乳突炎中，听骨链破坏与感音神经性听力损失相关；在鼓室-乳突炎中，长砧骨体破坏与 512 至 2048 Hz 的感音神经性听力损失呈强负相关（线性回归系数，截距分别为-2.84、-2.48 和-2.41；p=0.0024、0.0207 和 0.0076）。在鼓室-乳突炎中，穿孔大小与 512 至 2048 Hz 的感音神经性听力损失相关（Log 回归 p=0.0008、0.0252 和 0.0267；比值比，1.13、1.11 和 1.06）。鼓室-乳突炎患者中鼓室萎陷与感音神经性听力损失相关（p=0.022）。
慢性中耳炎患者感音神经性听力损失的预测因素包括中耳炎本身、年龄、听骨链破坏，尤其是砧骨长突破坏、广泛的迷路瘘管、穿孔大小和鼓膜内陷类型。
