CAJ | 학술논문

　　目的探讨骨导听阈提高的难治性分泌性中耳炎病因、诊断及治疗。方法回顾性分析2001年3月～2011年3月期间收治的骨导听阈提高的难治性分泌性中耳炎患者96例（148耳）临床资料，并以是否伴有腺样体肥大、变应性鼻炎或乳突病变分为3组。结果所有患耳均行鼓膜切开置管术，同时A组患者42例（70耳）并行腺样体切除术；B组患者22例（32耳）术后给予口服抗组胺药物及鼻用激素治疗；C组患者32例（46耳）予乳突手术治疗。鼓膜置管术后所有患耳于术后6个月拔管，78例（125耳）患者骨导听阈恢复正常；16例（21耳）患者骨导言语频率平均提高约11~25dBHL；2例（2耳）患者骨导听力无明显改善。术后91耳声导抗图为A型；21耳为B型；36耳为C型。结论提示伴有腺样体肥大、变应性鼻炎或乳突病变之难治性分泌性中耳炎与患者骨导听阈提高相关联，通过手术联合药物治疗解除相关致病因素、可有效提高患者骨导听力水平，阻止病情进一步发展，临床疗效满意。
　　목적탐토골도은역제고적난치성분비성중이염병인、진단급치료。방법회고성분석2001년3월～2011년3월기간수치적골도은역제고적난치성분비성중이염환자96례（148이）림상자료，병이시부반유선양체비대、변응성비염혹유돌병변분위3조。결과소유환이균행고막절개치관술，동시A조환자42례（70이）병행선양체절제술；B조환자22례（32이）술후급여구복항조알약물급비용격소치료；C조환자32례（46이）여유돌수술치료。고막치관술후소유환이우술후6개월발관，78례（125이）환자골도은역회복정상；16례（21이）환자골도언어빈솔평균제고약11~25dBHL；2례（2이）환자골도은력무명현개선。술후91이성도항도위A형；21이위B형；36이위C형。결론제시반유선양체비대、변응성비염혹유돌병변지난치성분비성중이염여환자골도은역제고상관련，통과수술연합약물치료해제상관치병인소、가유효제고환자골도은력수평，조지병정진일보발전，림상료효만의。
Objective To study the etiology, diagnosis and treatment of sensorineural hearing loss associated with refrac-tory secretory otitis media. Method Data from 96 patients (148 ears) with refractory secretory otitis media were retrospectively analyzed. The patients were divided into three groups based upon presence of comorbid adenoidal hypertrophy (Group A, n=42, 70 ears), allergic rhinitis (Group B, n=22, 32 ears) or mastoid diseases (Group C, n=32, 46 ears). All patients were treated with ventilation tube placement. At the same time, patients in Group A received adenoidectomy, those in Group B were given anti-histamine drugs and nasal steroids, and those in Group C received mastoid surgeries. Tympanostomy ventilation tubes were removed at 6 months. Results Bone conduction threshold returned to normal in 78 patients (125 ears), improved by,11 to 25dB in 16 cases (21 ears) and showed no improvement in 2 patients (2 ears). Postoperative tympanograms were type A in 91 ears, type B in 21 ears and type C in 36 ears. Conclusion Adenoidal hypertrophy, allergic rhinitis and mastoid diseases ap-pear to be related to bone conduction threshold changes in patients with refractory secretory otitis media. Effective manage-ment of these comorbidities can improve patients' bone conduction thresholds and prevent progression of disease, yielding sat-isfactory clinical results.