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題 名 | 鼓室成形術後骨導閾值的變化=Changes of Bone Conduction Threshold Following Tympanoplasty |
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作 者 | 陳柏蒼; 何坤瑤; 郭文烈; 蔡世盟; 李明芳; 林義峰; | 書刊名 | 中華民國耳鼻喉科醫學雜誌 |
卷 期 | 36:4 民90.07-08 |
頁 次 | 頁212-217 |
分類號 | 416.821 |
關鍵詞 | 骨導聽力閾值; 鼓室成形術; Bone conduction threshold; Tympanoplasty; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:臨床上常發現,有些慢性中耳炎的患者,在接受過鼓室成形術後,不僅氣導聽力改善,骨導聽力也跟著進步。為了了解鼓室成形術術後骨導閾值變化所代表的意義與相關性。本篇報告以術式別,和手術前後平均氣導聽力差別來分析鼓室成形術手術前後骨導閾值的變化。 方法:患者為慢性中耳炎,從1997年5月至1998年4月在高雄醫學大學耳鼻喉科由同一術者施行的鼓室成形術,排除先前存在的內耳傷害,共計收集91個病例,其中鼓室成形術type I 69例 type III 16例,type IV 6例。統計分析術前1個月內與術後6個月以上的純音聽力檢查。 結果:鼓室成形術type I,手術前後平均氣導聽力差為14.8 dB HL(p<0.01),手術後前平均骨導聽力差為3.0 dB HL(p<0.01)。鼓室成形術type III,手術前後平均氣導聽力差為7.5 dB HL(p<0.05),手術前後平均骨導聽力差為6.5 dB HL(p<0.01)。鼓室成形術type IV,手術前後平均導聽力差為-6.9 dB HL(p>0.05),手術前後平均骨導聽力差為-6.65 dB HL(p>0.05)。亦即鼓室成形術 type I 與 type III ,手術後平均氣導聽力和平均骨導聽力都明顯進步,而鼓室成形 type IV則否。手術後平均氣導聽力改善的病例,不僅術後平均骨導聽力明顯進步達統計上顯著意義,而且手術前後氣導聽力差與骨導聽力差呈現相關;即氣導聽力改善較多者,骨導聽力也進步較多。 結論:排除先前內耳傷害之原因,鼓室成形手術前後骨導聽力的改善,絕大部分肇因於中耳傳音系統重建而增進氣導聽力,以致氣導聽力改善後骨導聽力也跟著改善,換言之即受Carhart effect 的影響。 |
英文摘要 | BACKGROUND: Otologists have been increasingly concerned about the post-tympanoplasty bone conduction threshold differences in their clinical practice. The purpose of this study is to determine if patients with chronic otitis media (COM) present significant differences in bone conduction thresholds before and after tympanoplasty and to discuss the possible causes of such hone conduction changes. METHODS: Charts of all patients who had undergone chronic ear surgery performed by the same surgeon in the department of otorhinolaryngolgy at Kaohsiung Medical University from May 1997 to April 1998 were reviewed retrospectively. Included in the study were 91 Com patients with no history of post-traumatic tympanic membrane perforation, head trauma, labyrinthine, labyrinthine fistula, congenital cholesteatoma, previous otologic surgery, or coexisting otologic conditions. Changes in bone conduction threshold recorded by audiometric testing within one month of surgery and at least 6 months after surgery were statistically analyzed according to the type of tympanoplasty performed. RESULTS: There were statistical significance in the postoperative difference in both air and bone conduction thresholds in types I and III; while such statistical differences were not found in that of type IV. Our study also revealed that significant post-operative improvement in bone conduction thresholds coincided with improvement in post-operative air conduction thresholds; thereby it demonstrated a positive correlation between bone conduction and air conduction changes. CONCLUSIONS: tympanoplasty improves bone conduction thresholds, because it also restores the integrity of sound transmitting pathway in the inner ear. |
本系統中英文摘要資訊取自各篇刊載內容。