目的探讨伴乳突根治术的鼓室成形术、不伴乳突根治术的鼓室 成形术和单纯鼓膜修补术对中耳增益机制的不同影响,以及影响鼓室 成形术后听力的因素。 方法抽取在我院行鼓室成形术的 137 例患者。根据所作手术类 型分为伴乳突根治术的鼓室成形术、不伴乳突根治术的鼓室成形术和 单纯鼓膜修补术三组。用 U 检验对三组术式术后二周平均听阈及各 个频率听阈改善情况进行比较;用 Wilcoxon 检验对三组术后二周各 个频率听阈改善情况进行比较。绘散点图对不伴乳突根治术的鼓室成 形术及伴乳突根治术的鼓室成形术术后一年内及术后五年内的听力 情况进行分析。计算患者中耳危险指数(Middle Ear Risk Index ,MERI )分值。分析年龄、性别、病程、鼓膜穿孔面积、MERI 值对三组患者术后疗效的影响。 结果不伴乳突根治术的鼓室成形术组和伴乳突根治术的鼓室成 形术组术后二周平均听阈提高值差异有统计学意义(p<)。其中 低频听力改善差异显著(p<),而高频听力改善差异无统计学显 著意义(p>)。不伴乳突根治术的鼓室成形术组与单纯鼓膜修补 术组术后二周平均听阈及各个频率听阈提高值差异无统计学显著意 义(p>)。各鼓室成形术术后二周低频听力改善均较高频听力显 著(p<)。术后平均听阈提高值与年龄、病程、呈微弱负相关性, 与性别、鼓膜穿孔面积以及 MERI 值无明显相关性。 结论不伴乳突根治术的鼓室成形术对中耳增益效应影响显著, 能较好的改善术后听力,低频听力改善较为显著。鼓室成形术后短期 手术疗效与年龄、病程、性别、鼓膜穿孔面积及 MERI 值无显著相关 性。
关键词鼓室成形术,中耳增益机制,MERI 值 ANALYSIS OF HEARING RESULTS AFTER TYMPANOPLASTY --A STUDY ON THE PRESSURE GAINS AND OTHER FACTORS
ABSTRACT
Objective: The aim of this study was pare the acoustic pressure gained in different tympanoplasty. Study Design: Retrospective review of patient records. Subjects and methods: The charts of 137 patients who underwent different tympanoplasty operations were reviewed. They were divided into three groups. The hearing es after two weeks, 1 year and 5 years were analyzed. Nonparametric statistics was used to determine group differences. A probability value of p< was the level of significance selected. Prognostic factors such as age, sex, size of perforation, duration of medical history and middle ear risk index were investigated. Results: Significance better hearing results were observed in the tympanoplasty without mastoidectomy group, which is similar to those of the myringoplasty group, especially on the lower frequencies. There was no significant correlation between the hearing es and factors such as age, s
