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研究中耳慢性化脓性中耳炎砧骨坏死的术前指标。

To Study the Pre Operative Indicators of Incudal Necrosis in Tubo-Tympanic Chronic Otitis Media.

作者信息

Anjum Areena, Mir Shahid Ahmad, Khan Yasir Abbas, Kanotra Sonika

机构信息

Department of E.N.T, GMC Jammu and Associated Hospitals, Jammu, Jammu & Kashmir India.

DNB Neuroanesthesia, Department of Anesthesia, GIPMER, Delhi, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3374-3378. doi: 10.1007/s12070-024-04693-w. Epub 2024 Apr 18.

Abstract

To assess the pre-operative indicators of incudal necrosis in tubo-tympanic CSOM. A total of 80 patients with tubo-tympanic type of CSOM attending the SMGS Hospital ENT OPD/IPD of both genders were enrolled for the study. Pre-operative findings on oto-microscopic examination, pure-tone audiometry, x-ray mastoid and intra-operative microscopy was recorded. It was found that patients with age > 30 years and more than 10 years of CSOM had had higher incidence of ossicular necrosis as compared to patients age < 30 years and less than 10 years of CSOM ( < 0.05). Patients who had granulation tissue and moderate to moderately severe hearing loss had higher incidence of ossicular necrosis as compared to other patients. The difference was seen significant ( < 0.05). In this study, it was observed that the presence of granulations over the perforation margins, disease persisting for more than 10 years, moderate to moderately severe hearing loss appear to be significant reliable indicators of incudal necrosis in tubo-tympanic type of CSOM. All patients of tubo-tympanic type of CSOM should be assessed in detail so as to reach early diagnosis of ossicular erosion that helps in surgical decision making and preparedness regarding ossiculoplasty and patient consent.

摘要

评估中耳胆脂瘤型慢性化脓性中耳炎砧骨坏死的术前指标。共有80例中耳胆脂瘤型慢性化脓性中耳炎患者(男女均有)入选本研究,这些患者均在SMGS医院耳鼻喉科门诊/住院部就诊。记录耳镜检查、纯音听力测定、乳突X线检查及术中显微镜检查的术前结果。结果发现,年龄>30岁且慢性化脓性中耳炎病程超过10年的患者,与年龄<30岁且病程少于10年的患者相比,听小骨坏死的发生率更高(<0.05)。有肉芽组织且伴有中度至中度重度听力损失的患者,与其他患者相比,听小骨坏死的发生率更高。差异具有显著性(<0.05)。在本研究中,观察到穿孔边缘有肉芽、病程持续超过10年、中度至中度重度听力损失似乎是中耳胆脂瘤型慢性化脓性中耳炎砧骨坏死的重要可靠指标。所有中耳胆脂瘤型慢性化脓性中耳炎患者均应进行详细评估,以便尽早诊断听小骨侵蚀,这有助于手术决策以及关于听骨成形术的准备工作和患者知情同意。

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