Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
PLoS One. 2021 Mar 11;16(3):e0248421. doi: 10.1371/journal.pone.0248421. eCollection 2021.
Postoperative hearing improvement is one of the main expectations for patients receiving tympanoplasty. The capacity to predict postoperative hearing may help to counsel a patient properly and avoid untoward expectations. It is difficult to predict postoperative hearing without knowing the disease process in the middle ear, which can only be assessed intraoperatively. However, the duration and extent of the underlying pathologies may represent in bone-conduction threshold and air-bone gap. Here in patients undergoing tympanoplasty without ossiculoplasty, we sorted and separated the surgery dates into the first group to build the predicting models and the second group to test the predictions. There were 87 and 30 ears, respectively. No specific enrollment or exclusion criteria were based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions. The results show that bone-conduction threshold and air-bone gap together predicted air-conduction threshold after the surgery, including each frequency of 0.5k, 1k, 2k, and 4k Hz. The discrepancies between the predictions and recordings did not differ among these four frequencies. Of the variance in mean postoperative air-conduction threshold, 56.7% was linearly accounted for by these two preoperative predictors in this sample. The results suggest a trend that, the higher the frequency, the larger the part was accounted for by these two preoperative predictors. These together may help a surgeon to estimate frequency-specific hearing outcome after the surgery, answer patients' questions with quantitative statistics, and counsel patients with proper expectations.
术后听力改善是接受鼓室成形术患者的主要期望之一。预测术后听力的能力有助于对患者进行适当的咨询，并避免产生不良的预期。如果不了解中耳的疾病过程，就很难预测术后听力，而中耳的疾病过程只能在术中评估。然而，潜在病理的持续时间和程度可能会反映在骨导阈值和气骨导差上。在这里，我们对未进行听骨链重建的鼓室成形术患者进行了分组，将手术日期分为第一组和第二组，以建立预测模型并测试预测结果。第一组有 87 只耳朵，第二组有 30 只耳朵。没有根据鼓膜穿孔大小或中耳状况等潜在病理来确定特定的纳入或排除标准。结果表明，骨导阈值和气骨导差共同预测了手术后的气导阈值，包括 0.5k、1k、2k 和 4k Hz 的各个频率。这四个频率之间预测值与记录值之间的差异没有差异。在该样本中，这两个术前预测因子可解释平均术后气导阈值变化的 56.7%。结果表明，随着频率的升高，这两个术前预测因子所占的比例越大。这些因素可能有助于外科医生估计手术后特定频率的听力结果，用定量统计回答患者的问题，并对患者进行适当的咨询。
