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不进行鼓室成形术的根治性乳突切除术后的听力状况

Hearing Status after Radical Mastoidectomy without Tympanoplasty.

作者信息

Khan Shamaila Nawaz, Udaipurwala Iqbal Hussain, Mehmood Talat, Rahat Zahid Mehmood

机构信息

Department of Ear, Nose, Throat, Head & Neck Surgery, Bahria University Medical & Dental College and PNS Shifa Hospital, Karachi.

出版信息

J Coll Physicians Surg Pak. 2017 Dec;27(12):759-762.

PMID:29185402
Abstract

OBJECTIVE

To find out the impairment of hearing associated with radical mastoidectomy by measuring the quantitative difference in the functional hearing level before and after radical mastoidectomy operation without tympanoplasty.

STUDY DESIGN

Cross-sectional comparative study.

PLACE AND DURATION OF STUDY

Department of Otorhinolaryngology and Head Neck Surgery, Bahawal Victoria Hospital, Bahawalpur and PNS Shifa Hospital, Karachi, from November 2009 to January 2013.

METHODOLOGY

Eighty-five patients, diagnosed clinically as chronic suppurative otitis media with extensive cholesteatoma having history of ear discharge and hearing impairment for more than 6 weeks duration and requiring radical mastoidectomy for treatment, were included in this study. Pure tone audiogram was done before and after radical mastoidectomy. Hearing impairment was compared in each patient before and after the operation.

RESULTS

Among the 85 patients, 54 (63.5%) were males and 31 (36.5%) were females, with the age ranged between 18 to 63 years, mean age being 42.31 4.8 years. The mean increase in hearing loss after radical mastoidectomy in air conduction was 7.19 dB, bone conduction was 4.16 dB, and air-bone gap was 3.75 dB (0.001). The ear became dry and safe in 82 patients (96.5%) out of a total of 85, and only 3 patients required revision surgery at a second stage.

CONCLUSION

Radical mastoidectomy has a least negligible effect on hearing status and one should not limit this technique due to the concern of aggravated hearing in patients with extensive cholesteatoma at the cost of dry and safe ears, which should be of prime importance.

摘要

目的

通过测量在不进行鼓室成形术的乳突根治术后功能听力水平的定量差异,找出与乳突根治术相关的听力损害。

研究设计

横断面比较研究。

研究地点和时间

2009年11月至2013年1月,巴哈瓦尔布尔的巴哈瓦尔维多利亚医院耳鼻喉头颈外科以及卡拉奇的PNS希法医院。

方法

本研究纳入了85例临床诊断为慢性化脓性中耳炎伴广泛胆脂瘤、有耳漏和听力损害病史超过6周且需要进行乳突根治术治疗的患者。在乳突根治术前和术后进行纯音听力图检查。比较每位患者手术前后的听力损害情况。

结果

85例患者中,男性54例(63.5%),女性31例(36.5%),年龄在18至63岁之间,平均年龄为42.31±4.8岁。乳突根治术后气导听力损失平均增加7.19dB,骨导增加4.16dB,气骨导差为3.75dB(P<0.001)。85例患者中82例(96.5%)的耳朵变干且安全,只有3例患者需要二期翻修手术。

结论

乳突根治术对听力状况的影响极小,不应因担心广泛胆脂瘤患者听力加重而以耳朵变干且安全(这应是首要考虑因素)为代价限制该技术。

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