Reddy D Sanjana Krishna, Prasad K C
Department of ENT, Sri Devaraj Urs medical college, Tamaka, Kolar, Karnataka 563101 India.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):219-223. doi: 10.1007/s12070-023-04129-x. Epub 2023 Aug 10.
Chronic suppurative otitis media (CSOM) is a long standing infection of the middle ear cleft. Mastoidectomy, with or without tympanoplasty, is the preferred treatment for CSOM. However, the drill used during ear surgery generates noise that may potentially cause hearing damage in both the operated and opposite inner ear, leading to temporary or permanent hearing loss.
The study included patients diagnosed with CSOM who underwent surgeries in the Otorhinolaryngology department. Postoperatively, all patients were followed up on the 7th day and 1 month after the surgery. Pure Tone Audiometry (PTA) was performed to evaluate the hearing outcomes.
A total of 61 patients were included in the study. The mean preoperative PTA of contralateral ear bone conduction among the study participants was 6.48. At the 7th day post-operation, the mean post-operative PTA of contralateral ear bone conduction for the same participants was 7.77. This difference was statistically significant according to the Paired T-test (P = 0.001).However, when evaluating the mean preoperative PTA of contralateral ear bone conduction (6.48) and the mean post-operative PTA at 1st month (6.02), the difference was not statistically significant (P = 0.208).Additionally, there was no statistical difference in air conduction and air-bone gap before and after surgery.
The study suggests that mastoid drilling is associated with a significant temporary hearing loss in the contralateral ear immediately after surgery, which eventually recovers within a month. However, the hearing loss is considered negligible and not statistically significant in the long term. It is worth considering additional audiological investigations, such as otoacoustic emissions, to detect this type of hearing loss more accurately.
慢性化脓性中耳炎(CSOM)是中耳裂的一种长期感染性疾病。乳突根治术,无论是否联合鼓室成形术,都是治疗CSOM的首选方法。然而,耳部手术中使用的钻头会产生噪音,这可能会对手术侧和对侧内耳造成听力损害,导致暂时性或永久性听力损失。
本研究纳入了在耳鼻喉科接受手术的CSOM患者。术后,所有患者在术后第7天和1个月进行随访。采用纯音听力测试(PTA)评估听力结果。
本研究共纳入61例患者。研究参与者术前对侧耳骨导PTA的平均值为6.48。术后第7天,同一参与者对侧耳骨导术后PTA的平均值为7.77。根据配对t检验,这一差异具有统计学意义(P = 0.001)。然而,在评估术前对侧耳骨导PTA的平均值(6.48)和术后1个月的平均值(6.02)时,差异无统计学意义(P = 0.208)。此外,手术前后气导和气骨导间距也无统计学差异。
该研究表明,乳突钻孔术后对侧耳会立即出现明显的暂时性听力损失,但最终会在一个月内恢复。然而,从长期来看,这种听力损失被认为可以忽略不计,且无统计学意义。值得考虑进行额外的听力学检查,如耳声发射,以更准确地检测这种类型的听力损失。