Basset J M, Fleury P, Candau P, Bré M, Despreaux G, Perrin A, Vaillant A
Ann Otolaryngol Chir Cervicofac. 1985;102(4):239-49.
The authors undertook a study of changes in bone conduction (BC) during 800 operations carried out over a 5 years period (1979-1984) for chronic otitis or sequelae of chronic otitis. After elimination of ears with deafness (47) and cases unsuitable for evaluation (39), they finally included 714 records in the study. Only comparison of free and post-operative BC was made and using 4 conversational frequencies, not taking into account a deviation of 5 DB for each of these 4 frequencies. The study involved 317 myringoplasties: In 271 (i.e. 85,5%) there was no change in BC. Amongst them, 37 patients nevertheless showed a transient fall in BC. Of particular importance is the fact that almost 1/3 (11 to be exact) recovered only during the 2nd semester following surgery, a period which was even exceeded in the other 5 cases. 46 (i.e. 14.5%) were classified as "permanent" falls in BC. Amongst these in only 17 (i.e. 5%) were there "only" the three standard aggression factors for the I.O.: aspiration--scraping--manipulation of the tympano-ossicular system, without it being possible to attribute a predominant role to one more than the other. With regard to reaming of the E.A.M., those cases in which this could be considered responsible appeared to be infinitesimal. Furthermore, there was no statistically significant difference (reduced deviation test--"chi"2 test) between the number of falls in BC seen following myringoplasty with or without reaming. 83 tympanoplasties by Piston-Malleus, study of which led to the same conclusions as for myringoplasties. 118 masto-atticotomies, including 23 with posterior tympanotomy. Despite peri-labyrinthine and peri-ossicular scraping, results were essentially identical. 196 evacuation cavities (227-31 deafness) of which somewhat less than half only (46%) were ears undergoing surgery for the first time. Percentage of unchanged BC was here much more unfavourable, with 49 "permanent" falls in BC, i.e. 25%, of which, it must be said, 5 were minimal falls, and with, in 25 cases, a follow-up of less than 3 months.
作者对1979年至1984年期间因慢性中耳炎或慢性中耳炎后遗症进行的800例手术中的骨传导（BC）变化进行了研究。在排除失聪耳（47例）和不适合评估的病例（39例）后，他们最终将714份记录纳入研究。仅对术前和术后的骨传导进行了比较，使用了4个常用频率，未考虑这4个频率中每个频率5分贝的偏差。该研究包括317例鼓膜成形术：其中271例（即85.5%）骨传导无变化。其中，37例患者的骨传导仍出现短暂下降。特别重要的是，几乎三分之一（确切地说是11例）仅在术后第二学期恢复，另外5例甚至超过了这个时期。46例（即14.5%）被归类为骨传导“永久性”下降。其中只有17例（即5%）存在镫骨足板切开术的三个标准侵袭因素：吸引、刮擦和鼓室听骨系统操作，无法确定其中一个因素比另一个因素起更主要的作用。关于外耳道扩孔，可认为与此有关的病例似乎极少。此外，在鼓膜成形术中有或没有扩孔的情况下，骨传导下降的数量之间没有统计学上的显著差异（减少偏差检验——卡方检验）。83例采用活塞-锤骨鼓膜成形术，其研究结果与鼓膜成形术相同。118例乳突上鼓室切开术，包括23例后鼓室切开术。尽管进行了迷路周围和听骨周围刮擦，但结果基本相同。196例引流腔（227例-31例失聪），其中只有不到一半（46%）是首次接受手术的耳朵。骨传导无变化的比例在此处更不理想，有49例骨传导“永久性”下降，即25%，必须指出的是，其中5例是轻微下降，并且在25例中，随访时间不到3个月。
