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外伤性鼓膜穿孔患者的听力动态

Hearing dynamics in patients with traumatic tympanic membrane perforation.

作者信息

Sogebi O A, Oyewole E A, Manifah T O, Ogunbanwo O

机构信息

ENT Unit, Department of Surgery, College of Health Sciences, Olabisi Onabanjo University, Sagamu, Nigeria.

Department of Ear, Nose and Throat, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

出版信息

J West Afr Coll Surg. 2017 Apr-Jun;7(2):15-30.

Abstract

BACKGROUND

Hearing distortions from trauma to the ear could occur by direct perforation of the tympanic membrane.

AIM

To characterize hearing thresholds in patients with traumatic tympanic membrane perforation and changes in hearing occurring in the course of treatment.

STUDY DESIGN

Prospective analytical study.

SETTING

Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

METHODOLOGY

We prospectively entered in a proforma the demographics of 60 patients with traumatic tympanic membrane perforation at the teaching hospital in Sagamu, Nigeria over a period of five years as well as their hearing assessment with pure tone audiometry at initial contact and six weeks post-injury. The type of hearing loss, pure tone average and air-bone gaps were recorded. Hearing changes between initial and second audiometric assessments were analyzed and compared.

RESULTS

The data obtained from 60 patients with 73 traumatized ears were analyzed. In all, 64 (87.7%) of the ears had hearing loss while 33(45.2%) had conductive hearing loss. Injured ears had significantly worse hearing and higher air-bone gaps ABGs compared with non-traumatized ears. There was notable improvement in hearing thresholds and closure of air-bone gaps in the course of treatment, which was significantly more at the low frequencies compared with the high frequencies.

CONCLUSION

Patients with traumatic tympanic membrane perforation majorly had conductive hearing loss in the injured ears with audiometric confirmed air-bone gaps and increased hearing thresholds which were not frequency dependent. There was appreciable improvement in hearing parameters over time, significantly more at the low frequencies.

摘要

背景

耳部创伤导致的听力畸变可因鼓膜直接穿孔而发生。

目的

描述外伤性鼓膜穿孔患者的听力阈值以及治疗过程中发生的听力变化。

研究设计

前瞻性分析研究。

地点

尼日利亚萨加穆奥拉比西·奥纳班乔大学教学医院。

方法

我们前瞻性地将尼日利亚萨加穆教学医院5年内60例外伤性鼓膜穿孔患者的人口统计学数据以及他们在初次就诊时和受伤后6周时通过纯音听力测定法进行的听力评估录入表格。记录听力损失类型、纯音平均值和气骨导差。分析并比较初次和第二次听力测定评估之间的听力变化。

结果

对60例患者的73只受伤耳的数据进行了分析。总体而言,64只(87.7%)耳有听力损失,33只(45.2%)有传导性听力损失。与未受伤的耳朵相比,受伤的耳朵听力明显更差,气骨导差更高。在治疗过程中,听力阈值有显著改善,气骨导差缩小,低频改善程度明显高于高频。

结论

外伤性鼓膜穿孔患者受伤耳主要为传导性听力损失,听力测定证实存在气骨导差且听力阈值升高,且与频率无关。随着时间推移,听力参数有明显改善,低频改善更为显著。

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本文引用的文献

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[The Traumatic Tympanic Membrane Perforation - Aetiology and Therapy].[外伤性鼓膜穿孔——病因与治疗]
Laryngorhinootologie. 2015 Sep;94(9):596-600. doi: 10.1055/s-0034-1395522. Epub 2015 Jan 7.
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Mechanisms of hearing loss after blast injury to the ear.爆震性耳损伤后听力损失的机制。
PLoS One. 2013 Jul 1;8(7):e67618. doi: 10.1371/journal.pone.0067618. Print 2013.

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