Dhingani Gargi, Jadav Bhargav
C U Shah Medical College and Hospital, Surendranagar, Gujarat India.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):4276-4280. doi: 10.1007/s12070-021-02864-7. Epub 2021 Oct 24.
(1) To find the presence of middle ear diseases present in the patients with congenital bilateral severe to profound SNHL (2) If it poses as a threat to rehabilitative efforts for the existing severe to profound SNHL. Study setting: Department of ENT, C U Shah medical college and hospital. Study design: Prospective study Study population: Patients attending ENT department with complaints of congenital bilateral severe to profound sensorineural hearing loss. A total of 50 cases were studied during the study period. Methods of data collection: The Proforma was designed based on objective of the study. Detailed history was taken followed by thorough ENT and systemic examinations. Otoscopy and otoendoscopy were carried out and all patients were subjected to hearing tests consisting of Pure Tone Audiometry (PTA), Impedance Audiometry (IA), Brainstem Evoked Response Audiometry (BERA) and Oto Acoustic Emissions (OAE). HRCT and MRI scanning of temporal bones of all the patients was included as a part of the routine workup. Out of the 50 children with bilateral congenital hearing loss studied in this study, 13(26%) children were observed to have concurrent middle ear pathologies. 2 patients had bilateral retracted drum with tympanosclerosis; 3 had bilateral retraction pocketswith mastoiditis; 1 had bilateral SOM; 1 had right SOM and left retracted drum; 2 had bilateral PSQ cholesteatoma; 1 had left SOM and right sided tympanic membrane perforation, 3 had right sided tympanic membrane perforation with left sided normal ears. Children with congenital bilateral severe to profound hearing loss should be examined for middle ear pathologies, which can most often be overlooked otherwise, hence rendering the patient unfit for definitive management of the severe to profound SNHL in the form of Hearing Aid trial or Cochlear Implantation, further delaying the development of speech. Hence, all children with congenital bilateral severe to profound hearing loss should undergo regular screening for assessment of middle ear pathologies with prompt treatment when any middle ear pathology is encountered, therefore rendering the patient fit for fitting of cochlear implantation at the earliest possible to decrease permanent impairment of speech.
(1) 查找先天性双侧重度至极重度感音神经性听力损失患者中耳疾病的存在情况 (2) 其是否对现有的重度至极重度感音神经性听力损失的康复治疗构成威胁。研究地点：C U Shah医学院及医院耳鼻喉科。研究设计：前瞻性研究。研究对象：因先天性双侧重度至极重度感音神经性听力损失主诉前来耳鼻喉科就诊的患者。研究期间共研究了50例病例。数据收集方法：根据研究目的设计了表格。先采集详细病史，随后进行全面的耳鼻喉及全身检查。进行耳镜检查和耳内镜检查，所有患者均接受包括纯音听力测定（PTA）、声阻抗测听（IA）、脑干诱发电位测听（BERA）和耳声发射（OAE）在内的听力测试。所有患者颞骨的高分辨率CT（HRCT）和磁共振成像（MRI）扫描作为常规检查的一部分。在本研究中所研究的50例双侧先天性听力损失儿童中，观察到13例（26%）儿童同时患有中耳病变。2例患者双侧鼓膜内陷伴鼓室硬化；3例有双侧内陷袋伴乳突炎；1例有双侧浆液性中耳炎（SOM）；1例右侧SOM，左侧鼓膜内陷；2例有双侧原发性后天性胆脂瘤（PSQ）；1例左侧SOM，右侧鼓膜穿孔；3例右侧鼓膜穿孔，左侧耳朵正常。先天性双侧重度至极重度听力损失的儿童应检查是否存在中耳病变，否则这些病变最常被忽视，从而使患者不适合以助听器试验或人工耳蜗植入的形式对重度至极重度感音神经性听力损失进行确定性治疗，进而进一步延迟言语发育。因此，所有先天性双侧重度至极重度听力损失的儿童都应定期进行筛查，以评估中耳病变，一旦发现任何中耳病变应立即进行治疗，从而使患者尽早适合人工耳蜗植入，以减少言语的永久性损害。
