Carpenter David J, Tucci Debara L, Kaylie David M, Frank-Ito Dennis O
Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Computational Biology & Bioinformatics PhD Program, Duke University, Durham, NC, USA.
J Otol. 2017 Sep;12(3):125-131. doi: 10.1016/j.joto.2017.06.001. Epub 2017 Jun 29.
Recent studies have introduced middle ear volume (MEV) as a novel determinant of perforation-induced conductive hearing loss (CHL) in a mechanism driven by trans-tympanic membrane pressure differences. The primary aims of this preliminary report are to: 1) correlate CHL with perforation size; 2) describe the relationship between CHL and MEV; and 3) compare CHL across a range of cholesteatoma involvement.
A retrospective pilot study was performed in 31 subjects with audiometry indicative of conductive hearing loss, temporal bone CT scans, and no prior middle ear surgery. Perforation size and MEV were analyzed with respect to CHL in a cohort of 10 perforated ears with no cholesteatoma. CHLs were compared in 3 groups defined by extent of cholesteatoma involvement.
Ears with large and small perforations showed mean ABG values of 32.0 ± 15.7 dB and 16.0 ± 16.4 dB, respectively. A direct relationship was observed between MEV and CHL for ears with large perforations across all frequencies, whereas this relationship for small perforations was frequency-dependent. Finally, a statistically significant increase in CHL was found across ears with increasing cholesteatoma involvement at 1000 Hz (χ(2) = 9.786, p = 0.008), 2000 Hz (χ(2) = 8.455, p = 0.015), and 4000 Hz (χ(2) = 8.253, p = 0.016).
These pilot data suggest that greater perforation-induced conductive hearing losses may be associated with larger perforation sizes and cholesteatoma. The correlation between MEV and CHL may require additional study.
近期研究提出，中耳容积（MEV）是经鼓膜压力差驱动机制中穿孔性传导性听力损失（CHL）的一种新的决定因素。本初步报告的主要目的是：1）将CHL与穿孔大小相关联；2）描述CHL与MEV之间的关系；3）比较不同胆脂瘤累及范围的CHL情况。
对31名有传导性听力损失听力测定结果、颞骨CT扫描且既往无中耳手术史的受试者进行了一项回顾性试点研究。在一组10只无胆脂瘤的穿孔耳中，分析了穿孔大小和MEV与CHL的关系。根据胆脂瘤累及范围将受试者分为3组，比较各组的CHL情况。
大穿孔耳和小穿孔耳的平均气骨导差（ABG）值分别为32.0±15.7dB和16.0±16.4dB。在所有频率下，大穿孔耳的MEV与CHL之间存在直接关系，而小穿孔耳的这种关系则与频率有关。最后，发现在1000Hz（χ(2)=9.786，p=0.008）、2000Hz（χ(2)=8.455，p=0.015）和4000Hz（χ(2)=8.253，p=0.016）时，随着胆脂瘤累及范围增加，CHL有统计学意义的升高。
这些试点数据表明，更大的穿孔性传导性听力损失可能与更大的穿孔大小和胆脂瘤有关。MEV与CHL之间的相关性可能需要进一步研究。
