CAJ | 학술논문

目的探讨慢性化脓性中耳炎对老年患者骨导听阈的影响.方法回顾性分析2005年1月至2009年3月在北京同仁医院耳鼻咽喉头颈外科住院治疗且资料完整的60岁以上单侧慢性化脓性中耳炎患者76例,分别记录患侧耳与对侧耳0.5、1、2、4 kHz四个频率的骨导阈值,以及每例患者中耳炎发病持续时间、听骨链是否中断、是否存在胆脂瘤等情况,并对记录的数据进行统计学分析.结果患耳0.5、1、2、4 kHz四个频率的骨导阈值均高于对侧耳,差异有统计学意义(P值均＜0.01);胆脂瘤组与非胆脂瘤组相比,仅2 kHz双耳骨导阈值差的差异具有统计学意义(Z=-1.975,P=0.048);听骨链中断组与非中断组双耳骨导阙值差的差异也仅在2 kHz具有统计学意义(Z=-2.721,P=0.007);中耳炎病程10年以下组与10年以上组在1 kHz和2 kHz这两个频率的双耳骨导阈值差的差异具有统计学意义(Z值分别为-2.877和-2.624,P值均＜0.01).结论慢性化脓性中耳炎可以使老年患者骨导阈值提高,对于老年慢性化脓性中耳炎仍应尽早积极治疗,避免感音神经性听力损失.
목적 탐토만성화농성중이염대노년환자골도은역적영향.방법 회고성분석2005년1월지2009년3월재북경동인의원이비인후두경외과주원치료차자료완정적60세이상단측만성화농성중이염환자76례,분별기록환측이여대측이0.5、1、2、4 kHz사개빈솔적골도역치,이급매례환자중이염발병지속시간、은골련시부중단、시부존재담지류등정황,병대기록적수거진행통계학분석.결과 환이0.5、1、2、4 kHz사개빈솔적골도역치균고우대측이,차이유통계학의의(P치균＜0.01);담지류조여비담지류조상비,부2 kHz쌍이골도역치차적차이구유통계학의의(Z=-1.975,P=0.048);은골련중단조여비중단조쌍이골도궐치차적차이야부재2 kHz구유통계학의의(Z=-2.721,P=0.007);중이염병정10년이하조여10년이상조재1 kHz화2 kHz저량개빈솔적쌍이골도역치차적차이구유통계학의의(Z치분별위-2.877화-2.624,P치균＜0.01).결론 만성화농성중이염가이사노년환자골도역치제고,대우노년만성화농성중이염잉응진조적겁치료,피면감음신경성은력손실.
Objective To research the effects of chronic suppurative otitis media on bone conduction threshold in old patients. Methods The files of patients with unilateral chronic otitis media were retrospective analyzed, who were all oder than 60 years, who were inpatient in our department since January 2005 to March 2009. Conventional puretone audiometry test was carried out. Bone conduction thresholds were calculated for frequencies of 0. 5, 1,2, and 4 kHz, with comparison between the ear with chronic otitis media and controlateral ear. Thresholds were examined separately for each frequency. Results The bone conduction threshold for the normal side was lower than those for the ear with chronic otitis media. The threshold shift was statistically significant for each frequency(P ＜0. 01 ). There were no diverences between the groups when analyzed for the presence of cholesteatoma except at 2 kHz frequencies ( Z = - 1. 975,P = 0. 048). There were diverences between the groups when analyzed for an interruption of the ossicular chain only at 2 kHz frequencies ( Z = - 2. 721, P = 0. 007 ). There were diverences between the groups when the duration of middle ear disease was not same at 1 kHz and 2 kHz frequencies( Z value were - 2. 877,-2. 624, P＜0. 01, respectively). Conclusions This study shows that chronic otitis media can enhance bone conduction threshold for old patients. All measures for early cure should be considered as early as possible in oder patients with chronic otitis media to prevent advance of sensorineural hearing loss.