Ohbuchi Toyoaki, Suzuki Hideaki, Hohchi Nobusuke, Ohkubo Jun-Ichi, Hashida Koichi
Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2012 Sep 1;34(3):231-5. doi: 10.7888/juoeh.34.231.
Although otosclerosis is essentially a middle ear disease, patients with this disease often exhibit mixed hearing loss. This discrepancy is thought to be explained by the following mechanism: the resonance of the ossicular chain is disturbed by the fixation of stapes, leading to the attenuation of inertial bone conduction. The bone-conduction hearing level usually recovers after stapes surgery. We herein studied the change in air- and bone-conduction hearing after stapes surgery in patients with otosclerosis. Six consecutive patients with otosclerosis who underwent stapes surgery in our department were enrolled. They were 2 men and 4 women, ranging in age from 16 to 74 with an average of 57.2 years. Stapedotomy was performed in 5 patients, and the other patient underwent partial stapedectomy. Their pure tone hearing levels of air and bone conduction were measured before and after surgery. In the air conduction, the hearing levels at 125, 250, 500, 1000, 2000, and 4000 Hz significantly improved after surgery, but showed no significant change at 8000 Hz. On the other hand, in the bone conduction, the hearing levels at 500 and 1000 Hz significantly improved after surgery, whereas those at 250, 2000, and 4000 Hz showed no significant change. The recovery of the bone conduction hearing at 500 and 1000 Hz is explained by the resonance of the ossicular chain. However, the unimproved bone conduction hearing at 2000 Hz is unexplainable, and remains to be further investigated in future studies.
虽然耳硬化本质上是一种中耳疾病，但患有这种疾病的患者常表现出混合性听力损失。这种差异被认为可通过以下机制来解释：镫骨固定会干扰听骨链的共振，导致惯性骨传导减弱。镫骨手术后骨传导听力水平通常会恢复。我们在此研究了耳硬化患者镫骨手术后气导和骨导听力的变化。纳入了在我们科室接受镫骨手术的6例连续耳硬化患者。其中男性2例，女性4例，年龄16至74岁，平均57.2岁。5例患者行镫骨足板切除术，另1例患者行部分镫骨切除术。测量了他们手术前后的气导和骨导纯音听力水平。在气导方面，术后125、250、500、1000、2000和4000Hz的听力水平显著改善，但8000Hz时无显著变化。另一方面，在骨导方面，术后500和1000Hz的听力水平显著改善，而250、2000和4000Hz时无显著变化。500和1000Hz骨传导听力的恢复可通过听骨链的共振来解释。然而，2000Hz时骨传导听力未改善的原因尚无法解释，有待未来进一步研究。
