Subramaniam Vijayalakshmi, Ashkar Ali, Rai Sheetal
Department of Otorhinolaryngology, Yenepoya Medical College, Mangalore city, Karnataka State, India.
Assistant Surgeon, Government Taluk Hospital, Trikaripur Kasargod District, Kerala state, India.
Iran J Otorhinolaryngol. 2020 Mar;32(109):79-84. doi: 10.22038/ijorl.2019.35045.2158.
Long-standing chronic otitis media (COM) may lead to sensorineural hearing loss (SNHL). The present study aimed to evaluate the factors affecting the sensorineural component to counsel patients regarding the risk of SNHL at the event of untreated COM.
A time-bound cross-sectional study was conducted in the Department of Otorhinolaryngology at a tertiary care hospital. The study population included the study group comprising 137 patients with chronic suppurative otitis media (CSOM) and the control group which consisted of 137 individuals with the same age range and gender as the case study group. Moreover, the hearing was assessed using a pure tone audiogram and special tests of hearing.
Based on the findings of the present study, the SNHL was found in 71.4% of CSOM cases with an ear discharge duration of more than 5 years. The SNHL occurred in 55.2% and 44.7% of the cases with pars flaccida and of pars tensa perforations, respectively. In the case of pars tensa perforation, greater perforation size resulted in a steady increase in the odds of developing SNHL. Patients with subtotal and total perforations were at higher risk of developing SNHL.
Patients with longer duration of disease, squamous type of disease, and larger size of pars tensa perforation had greater susceptibility to develop SNHL. Therefore, eradication of the disease from the middle ear and early reconstruction of the hearing mechanism during the course of the disease result in reducing the burden of SNHL.
长期慢性中耳炎(COM)可能导致感音神经性听力损失(SNHL)。本研究旨在评估影响感音神经成分的因素,以便在未经治疗的COM患者发生SNHL风险时为其提供咨询。
在一家三级护理医院的耳鼻喉科进行了一项有时间限制的横断面研究。研究人群包括由137例慢性化脓性中耳炎(CSOM)患者组成的研究组和由137名年龄范围和性别与病例研究组相同的个体组成的对照组。此外,使用纯音听力图和特殊听力测试对听力进行评估。
根据本研究的结果,在耳漏持续时间超过5年的CSOM病例中,71.4%发现有感音神经性听力损失。松弛部穿孔和紧张部穿孔的病例中,感音神经性听力损失分别发生在55.2%和44.7%的病例中。在紧张部穿孔的情况下,穿孔尺寸越大,发生感音神经性听力损失的几率稳步增加。部分穿孔和全穿孔患者发生感音神经性听力损失的风险更高。
病程较长、鳞状病变类型和紧张部穿孔尺寸较大的患者发生感音神经性听力损失的易感性更高。因此,在疾病过程中清除中耳疾病并尽早重建听力机制可减轻感音神经性听力损失的负担。