Latheef Muhammed Nabeel, Karthikeyan P, Coumare V Nirmal
Department of ENT, Mahatma Gandhi Medical College and Research Institute, Pondy-Cuddalore Main Road, Pillaiyarkuppam, Pondicherry, 607 402 India.
Indian J Otolaryngol Head Neck Surg. 2018 Jun;70(2):205-210. doi: 10.1007/s12070-017-1064-y. Epub 2017 Jan 21.
To evaluate hearing of the contralateral normal ear before and after mastoidectomy in a longitudinal manner and to assess whether the hearing loss is transient or permanent and to find out the duration of temporary hearing loss. This was a clinical longitudinal observational study involving 50 patients with unilateral chronic suppurative otitis media requiring mastoidectomy operation over a period of 18 months after satisfying the inclusion criteria. During the part of the mastoidectomy surgery involving drilling of the mastoid bone, noise levels were recorded at multiple points in the surgery using a digital sound level meter. Postoperatively, beginning from Day 1 to Day 7, PTA and OAE of the contralateral ear were recorded for all patients. The patients were then followed up at 1, 3 and 6 months postoperatively, at which times PTA and OAE were repeated. There is an increase in the absence of High Frequency DPOAEs on the first and second postoperative days, but this increase is higher than that of Low Frequency DPOAEs and gradually returns to normal by 72 h. OAEs were found to be more sensitive at diagnosing and tracking the progress of affected patients. All affected ears only had a temporary postoperative hearing loss, primarily affecting the higher frequencies and returning to normal within 72 h. Drill-generated noise and vibration during mastoidectomy operation is associated with a significant temporary shift in hearing thresholds of the contralateral normal ear in susceptible individuals, affecting the higher frequencies, and is best evaluated using DPOAEs.
以纵向方式评估乳突切除术前和术后对侧正常耳的听力,评估听力损失是短暂性还是永久性的,并找出暂时性听力损失的持续时间。这是一项临床纵向观察性研究,纳入标准符合后,在18个月内纳入了50例需要进行乳突切除术的单侧慢性化脓性中耳炎患者。在乳突切除术涉及磨除乳突骨的部分手术过程中,使用数字声级计在手术中的多个点记录噪声水平。术后,从第1天到第7天,记录所有患者对侧耳的纯音听阈(PTA)和耳声发射(OAE)。然后在术后1、3和6个月对患者进行随访,此时重复测量PTA和OAE。术后第1天和第2天,高频畸变产物耳声发射(High Frequency DPOAEs)缺失增加,但这种增加高于低频畸变产物耳声发射(Low Frequency DPOAEs),并在72小时逐渐恢复正常。发现耳声发射在诊断和跟踪受影响患者的病情进展方面更敏感。所有受影响的耳朵术后仅有暂时性听力损失,主要影响高频,并在72小时内恢复正常。乳突切除术中钻头产生的噪声和振动与易感性个体对侧正常耳听力阈值的显著暂时性变化有关,影响高频,使用畸变产物耳声发射(DPOAEs)评估最佳。