Koch U
Laryngol Rhinol Otol (Stuttg). 1980 Sep;59(9):495-505.
In 71 patients with adhesive processes the development and rate of recidives after tymplasty is studied by clinical and tympanometric observation. The typical tympanogram in adhesive processes is flattened with a peak in the negative pressure area. Initially after tympanoplasty permanent aeration was secured by grommets. When these came out and the tympanic membrane was closed, most of the cases showed almost normal tympanograms. Within 3 months in most cases the preoperative tympanogram re-developed, regardless what the tube function was like. The typical peak in the negative area must not necessarily be caused by negative pressure in the middle ear - as we could demonstrate in model studies. These results correspond closely to the clinical findings. The enlargement of the middle ear cavity by tympanoplastics can only be obtained by permanent aeration. When the tympanic membrane is closed - regardless of the tube function - often new retractions occur, which can easily lead to recidives of the adhesive process. Hearing tests showed close correlations to the tympanometric findings. Hearing is improved as long as the grommet secure permenent aeration; when the tympanic membrane is closed, it may become worse during a very short period. Correlations between hearing and the mobility of the tympanic membrane and ossicles in adhesive processes could be shown in the tympanoaudiogram.
对71例患有粘连性病变的患者，通过临床和鼓室图观察研究了鼓室成形术后复发的情况及复发率。粘连性病变的典型鼓室图呈扁平状，在负压区有一个峰值。鼓室成形术后最初通过鼓膜通气管确保了永久性通气。当通气管脱出且鼓膜封闭后，大多数病例的鼓室图几乎正常。在大多数情况下，术后3个月内术前的鼓室图再次出现，无论通气管功能如何。如我们在模型研究中所证明的，负压区的典型峰值不一定是由中耳负压引起的。这些结果与临床发现密切相符。鼓室成形术扩大中耳腔只能通过永久性通气来实现。当鼓膜封闭时——无论通气管功能如何——常常会出现新的内陷，这很容易导致粘连性病变复发。听力测试结果与鼓室图结果密切相关。只要鼓膜通气管确保永久性通气，听力就会改善；当鼓膜封闭时，听力可能在很短时间内变差。在鼓室听力图中可以显示粘连性病变中听力与鼓膜和听小骨活动度之间的相关性。
