Prenzler N K, Schwab B, Kaplan D M, El-Saied S
Otorhinolaryngology Department, Head and Neck Surgery, Hanover Medical University, Hannover, Germany.
Department of Otolaryngology - Head and Neck Surgery, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel.
Am J Otolaryngol. 2018 Jan-Feb;39(1):46-49. doi: 10.1016/j.amjoto.2017.10.006. Epub 2017 Oct 9.
The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome.
Retrospective study of all patients diagnosed with SSNHL who underwent explorative tympanotomy between 2002 and 2005.
Tertiary care university-affiliated hospital.
Eighty-two patients were diagnosed with unilateral profound SSNHL and underwent tympanotomy with sealing of the round and oval windows. Values of pure tone audiograms and percentage hearing loss of patients with and without intraoperative diagnosed perilymphatic fistula (PLF) were compared and analyzed.
PLF was diagnosed in 28% cases intraoperatively. In most cases, hearing improved significantly after surgery. Interestingly, patients with PLF had a 2.4 times greater decrease of percentage hearing loss compared to patients without PLF.
Explorative tympanotomy seems to be useful in patients with profound SSNHL. Patients with PLF benefit more from the surgical procedure and have better outcome than patients without PLF.
本研究的目的是描述探查性鼓室切开术在无外淋巴瘘或迷路瘘临床证据的极重度突发性感音神经性听力损失（SSNHL）患者中的作用，并比较术中发现与术后听力结果。
对2002年至2005年间接受探查性鼓室切开术的所有被诊断为SSNHL的患者进行回顾性研究。
大学附属三级护理医院。
82例患者被诊断为单侧极重度SSNHL，并接受了封闭圆窗和卵圆窗的鼓室切开术。比较并分析了术中诊断有外淋巴瘘（PLF）和无外淋巴瘘患者的纯音听力图值和听力损失百分比。
术中诊断出28%的病例有PLF。在大多数情况下，术后听力有显著改善。有趣的是，与无PLF的患者相比，有PLF的患者听力损失百分比下降幅度大2.4倍。
探查性鼓室切开术似乎对极重度SSNHL患者有用。有PLF的患者从手术中获益更多，且比无PLF的患者预后更好。
