Zhang HongJia, Han ZeLi, Li Yue, Lin JiaHua, Zou YiHui
Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Beijing, China.
National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.
Acta Otolaryngol. 2023 Nov;143(sup1):S45-S48. doi: 10.1080/00016489.2023.2281504. Epub 2024 Feb 13.
There is no report on the relationship between congenital malformation of the outer ear and hearing, which makes it possible to predict the hearing level just based on microtia grades. To investigate the correlation between two types of congenital malformation of the outer ear [microtia and Outer Ear Canal Malformation (OECM)] and hearing, as well as the interrelationship among all three variables. A total of 535 cases (598 ears) of congenital malformation of the middle and outer ear (CMMOE) with hearing data, out of which 319 cases (349 ears) microtia with available images and graded by I-V, 449 cases (482 ears) OECM graded by atresia, stenosis and normal, and 87 cases (87 ears) OEC atresia graded I-IV, 301 cases (301 ears) with materials of microtia, OECM and hearing at the same time were carried out correlation analysis. The Average Air-Conduction Threshold of pure tone (AACT) at 0.5-4 KHz was calculated corresponding to the ears with different malformation grades. The differences in AACT among different malformation grades, the correlation between malformation severity and AACT, as well as the relationship among microtia, OECM and AACT were analyzed. The one-way analysis of variance (ANOVA) was employed to compare the differences in AACT, Kendall's tau-b rank correlation coefficient test was used for correlation analysis. A statistical significance level of < 0 .05 was applied. Among the 349 ears with microtia, the corresponding AACT values for grades I to V were 61.6, 63.0, 69.9, 75.4, and 75.0 (dB HL), respectively. Comparing grade III to grades II or IV, both < 0 .05. However, > 0 .05 between grade I and II or between grade IV and V. The correlation coefficient between microtia grades and AACT = 0.219, < 0.05. Among the 482 ears of OECM, the distribution was as follows: 73.6% atresia, 19.1% stenosis, and 7.3% normal, the corresponding AACT values were 64.1, 61.7, and 52.5 (dB HL), respectively. Comparing normal to stenosis or atresia, both < 0.05, while between atresia and stenosis > 0.05. The correlation between OECM and AACT was = 0.104, < 0.05. The AACT values corresponding to grades I to IV of OEC atresia in the 87 ears were 59.9, 65.1, 71.1, and 64.1 (dB HL), respectively. Comparing these grades, all > 0.05. The correlation between the degree of atresia and AACT = 0.23, < 0 .05. The correlation coefficients for 301 ears microtia to OECM, microtia to AACT, OECM to AACT were = 0.339, = 0.163 and = 0.128 respectively, with all < 0 .05. There are positive correlations among the degree of microtia, degree of OECM, and AACT values for each other, and so between the degree of OEC atresia and AACT, suggesting that as the severity of microtia or OECM increased, the AACT also tended to be higher, which make it possible to predict the hearing level and the degree of OECM based on microtia grades in clinical practice. Additionally, there are significant differences in AACT values in microtia grade III to grades II or IV, OEC normal to stenosis or atresia, while no differences in microtia grade I to II and grade IV to V, OEC stenosis to atresia, and among the grades I-IV of the OEC atresia.
目前尚无关于外耳先天性畸形与听力之间关系的报道，这使得仅根据小耳畸形的分级来预测听力水平成为可能。为了研究两种外耳先天性畸形[小耳畸形和外耳道畸形（OECM）]与听力之间的相关性，以及这三个变量之间的相互关系。共有535例（598耳）中耳和外耳先天性畸形（CMMOE）且有听力数据的病例，其中319例（349耳）小耳畸形有可用图像并按I - V级分级，449例（482耳）OECM按闭锁、狭窄和正常分级，87例（87耳）OEC闭锁按I - IV级分级，对301例（301耳）同时具有小耳畸形、OECM和听力资料的病例进行相关性分析。计算了对应不同畸形分级耳的0.5 - 4kHz纯音平均气导阈值（AACT）。分析了不同畸形分级之间AACT的差异、畸形严重程度与AACT之间的相关性，以及小耳畸形、OECM和AACT之间的关系。采用单因素方差分析（ANOVA）比较AACT的差异，使用肯德尔tau - b等级相关系数检验进行相关性分析。应用统计学显著性水平<0.05。在349例小耳畸形耳中，I至V级对应的AACT值分别为61.6、63.0、69.9、75.4和75.0（dB HL）。III级与II级或IV级比较，均<0.05。然而，I级与II级之间或IV级与V级之间>0.05。小耳畸形分级与AACT之间的相关系数 = 0.219，<0.05。在482例OECM耳中，分布如下：闭锁占73.6%，狭窄占19.1%，正常占7.3%，对应的AACT值分别为64.1、61.7和52.5（dB HL）。正常与狭窄或闭锁比较，均<0.05，而闭锁与狭窄之间>0.05。OECM与AACT之间的相关性为 = 0.104，<0.05。87例OEC闭锁I至IV级对应的AACT值分别为59.9、65.1、71.1和64.1（dB HL）。比较这些分级，均>0.05。闭锁程度与AACT之间的相关性 = 0.23，<0.05。301例耳中小耳畸形与OECM、小耳畸形与AACT、OECM与AACT的相关系数分别为 = 0.339、 = 0.163和 = 0.128，均<0.05。小耳畸形程度、OECM程度和AACT值之间相互呈正相关，OEC闭锁程度与AACT之间也是如此，这表明随着小耳畸形或OECM严重程度的增加，AACT也趋于升高，这使得在临床实践中基于小耳畸形分级来预测听力水平和OECM程度成为可能。此外，小耳畸形III级与II级或IV级之间、OEC正常与狭窄或闭锁之间AACT值存在显著差异，而小耳畸形I级与II级之间、IV级与V级之间、OEC狭窄与闭锁之间以及OEC闭锁I - IV级之间无差异。
