CAJ | 학술논문

目的总结分析混合性聋的原因、听力重建术的方法及效果。方法回顾性分析32例混合性聋且行听力重建手术治疗患者的临床资料，分析其病因及根据不同病因所采取的听力重建手术方法，比较手术前后各频率气导听阈、骨导听阈、气骨导差及言语频率平均听阈，观察治疗效果。结果32例患者中，慢性化脓性中耳炎15例、耳硬化症13例、Van der Hoeve综合征2例、先天性中耳畸形2例；听力重建术后言语频率气导听力提高15 dB以上者26例，有效率为81．25％（26/32），全部患者术后言语频率气、骨导听力分别提高24．94±8．15 dB和5．90±7．96 dB ，气骨导差缩小19．04±11．06 dB（P＜0．05）。术后0．25～4 kHz气导听力较术前有不同程度提高（P＜0．05），而手术前后8 kHz气导听力无明显变化（P＞0．05）；术后骨导听力在1、2 kHz处有提高（P＜0．05），在2 kHz处提高最明显。结论混合性聋多见于耳硬化症、慢性化脓性中耳炎、鼓室硬化等疾病。听力重建手术是治疗混合性聋的有效方法。
목적총결분석혼합성롱적원인、은력중건술적방법급효과。방법회고성분석32례혼합성롱차행은력중건수술치료환자적림상자료，분석기병인급근거불동병인소채취적은력중건수술방법，비교수술전후각빈솔기도은역、골도은역、기골도차급언어빈솔평균은역，관찰치료효과。결과32례환자중，만성화농성중이염15례、이경화증13례、Van der Hoeve종합정2례、선천성중이기형2례；은력중건술후언어빈솔기도은력제고15 dB이상자26례，유효솔위81．25％（26/32），전부환자술후언어빈솔기、골도은력분별제고24．94±8．15 dB화5．90±7．96 dB ，기골도차축소19．04±11．06 dB（P＜0．05）。술후0．25～4 kHz기도은력교술전유불동정도제고（P＜0．05），이수술전후8 kHz기도은력무명현변화（P＞0．05）；술후골도은력재1、2 kHz처유제고（P＜0．05），재2 kHz처제고최명현。결론혼합성롱다견우이경화증、만성화농성중이염、고실경화등질병。은력중건수술시치료혼합성롱적유효방법。
Objective To summarize and analyze the pathogenesis ,methods of hearing reconstruction and curative effect of mixed hearing loss .Methods Patients with mixed hearing loss who underwent hearing reconstruc-tion from Jan 2009 to Dec 2011 in the ENT department of PLA General hospital were reviewed retrospectively .Af-ter the operation ,air conduction (AC) ,bone conduction (BC) ,air-bone gap (ABG) at main frequencies and audi-ometry changes were analyzed .Results Among 32 cases ,15 cases were chronic otitis media ,13 cases otosclerosis , 2 cases Van der Hoeve ,and 2 cases congenital middle ear malformations .There were 26 cases with significantly im-proved hearing after surgery ,and the effective rate was 81 .25% .AC showed great improvement at 0 .25~4 kHz (P<0 .05) while there was no change at 8 kHz (P>0 .05) .BC showed improvements at 1 and 2 kHz and improved significantly only at 2 kHz .After operation ,pure tone audiometry at AC and BC separately improved 24 .94 ± 8 .15 dB and 5 .90 ± 7 .96 dB;ABG narrowed down to 19 .04 ± 11 .06 dB .Conclusion Mixed hearing losses are mostly seen in chronic otitis media and tympanosclerosis .After auditory rehabilitation ,patients can experience improved hearing .