CAJ | 학술논문

背景:国内外尚缺乏一种行之有效的评估系统来评估慢性化脓性中耳炎的治疗效果,主观听力改善是判断鼓膜成形成功与否最重要的标准.目的:观察耳屏软骨环-软骨膜鼓膜成形后听力疗效,并对其相关影响因素进行分析.方法:耳屏软骨环-软骨膜行鼓膜成形后患者240例随访3年,追踪观察鼓膜生长情况及行纯音听阈检查,并记录患者日常生活中听力改善情况.对可能影响疗效的10项因素进行多元线性回归分析.结果与结论:使用多元线性回归对可能影响鼓膜成形后听力的因素进行筛选,按其作用大小依次为:鼓膜成形前气导听阈平均值、干耳时间、病程、年龄.主观听力的改变与客观听力的改变具有相关性.鼓膜成形前气骨导差与鼓膜成形后主观听力情况的比较83.3%鼓膜成形后主观听力有明显改善;鼓膜成形后气导阈值与主观听力改善的比较,鼓膜成形后主观听力有明显改善(83.9%).鼓膜成形后气导听阈下降≤10 dB 的患者中54.5%有主观听力改善;而气导听阈下降30 dB 以上时,97.8%的患者主观听力改善.提示主观听力改善的程度与鼓膜成形后气导阈值下降的程度成正相关,鼓膜成形后气导听阈下降越多,其主观听力改善越明显.
배경:국내외상결핍일충행지유효적평고계통래평고만성화농성중이염적치료효과,주관은력개선시판단고막성형성공여부최중요적표준.목적:관찰이병연골배-연골막고막성형후은력료효,병대기상관영향인소진행분석.방법:이병연골배-연골막행고막성형후환자240례수방3년,추종관찰고막생장정황급행순음은역검사,병기록환자일상생활중은력개선정황.대가능영향료효적10항인소진행다원선성회귀분석.결과여결론:사용다원선성회귀대가능영향고막성형후은력적인소진행사선,안기작용대소의차위:고막성형전기도은역평균치、간이시간、병정、년령.주관은력적개변여객관은력적개변구유상관성.고막성형전기골도차여고막성형후주관은력정황적비교83.3%고막성형후주관은력유명현개선;고막성형후기도역치여주관은력개선적비교,고막성형후주관은력유명현개선(83.9%).고막성형후기도은역하강≤10 dB 적환자중54.5%유주관은력개선;이기도은역하강30 dB 이상시,97.8%적환자주관은력개선.제시주관은력개선적정도여고막성형후기도역치하강적정도성정상관,고막성형후기도은역하강월다,기주관은력개선월명현.
BACKGROUND: At present, there is stil lack of a valid valuation system for evaluating chronic maturation treatment effect and subjective hearing improvement is the most important criteria to judge the success of myringoplasty. OBJECTIVE: To evaluate the hearing results fol owing the tragus cartilage ring with perichondrium in myringoplasty and to analyze the related impact factors. METHODS: A total of 240 patients treated with tragus cartilage ring with perichondrium in myringoplasty were selected and fol owed-up for 3 years, then the eardrum growth was tracking observed and the pure tone threshold checking was performed, and then the hearing improvement was daily recorded. Multiple linear regression analysis was performed on 10 factors that may affect the efficacy. RESULTS AND CONCLUSION: Multiple linear regression statistical analysis was subsequently carried out on these prognostic factors of hearing outcomes and yielded the fol owing relative importance of predictive as fol ows; mean preoperative air conduction threshold, duration of dry ear, duration of disease and age. The subjective hearing changes were correlated with the objective hearing changes. Comparing the preoperative airbone gap and the postoperative subjective hearing ability, we found that the subjective hearing ability of 83.3% patients was significantly improved; comparison between preoperative air conduction threshold and postoperative subjective hearing ability showed that the subjective hearing ability of about 83.9% patients were significantly improved. Among the patients with decreased air conduction threshold less than 10 dB, the subjective hearing of 54.5% patients was improved; and when the air conduction threshold decreased more than 30 dB, the subjective hearing of 97.8% patients was improved. It suggests that the improvement degree of the subjective hearing is positively correlated with the decreasing degree of the air conduction threshold after myringoplasty, the more the air conduction threshold decreased, the more the subjective hearing improved.