Berger G, Finkelstein Y, Avraham S, Himmelfarb M
Department of Otolaryngology-Head and Neck Surgery, Meir General Hospital, Kfar Saba, Israel.
J Laryngol Otol. 1997 Dec;111(12):1137-41. doi: 10.1017/s0022215100139544.
A prospective study of hearing loss in 120 cases with non-explosive blast injury of the ear, gathered over a six-year period, is presented. Thirty-three (27.5 per cent) patients had normal hearing, 57 (47.5 per cent) conductive hearing loss, 29 (24.2 per cent) mixed loss and one (0.8 per cent) had pure sensorineural loss. The severity of conductive hearing loss correlated with the size of the eardrum perforation; only a marginal difference was found between water and air pressure injuries, with respect to this type of hearing loss. Of all locations, perforations involving the posterior-inferior quadrant of the eardrum were associated with the largest air-bone gap. Audiometric assessment revealed that none of the patients suffered ossicular chain damage. Three patterns of sensorineural hearing loss were identified: a dip at a single frequency, two separate dips, and abnormality of bone conduction in several adjacent high frequencies. Involvement of several frequencies was associated with a more severe hearing loss than a dip in a single frequency. Healing of the perforation was always accompanied by closure of the air-bone gap, while the recovery of the sensorineural hearing loss was less favourable.
本文呈现了一项为期六年的前瞻性研究，该研究针对120例非爆炸性耳部爆震伤患者的听力损失情况展开。33例（27.5%）患者听力正常，57例（47.5%）为传导性听力损失，29例（24.2%）为混合性听力损失，1例（0.8%）为单纯感音神经性听力损失。传导性听力损失的严重程度与鼓膜穿孔大小相关；就此类听力损失而言，水压伤和气压伤之间仅存在微小差异。在所有位置中，涉及鼓膜后下象限的穿孔与最大的气骨导间距相关。听力测定评估显示，所有患者均未出现听骨链损伤。确定了三种感音神经性听力损失模式：单个频率的下降、两个单独的下降以及几个相邻高频的骨导异常。多个频率受累比单个频率下降导致的听力损失更严重。穿孔愈合总是伴随着气骨导间距的闭合，而感音神经性听力损失的恢复则不太理想。
