摘要
目的分析鼓膜张肌腱的完整性对鼓室成形术后鼓膜形态及听力重建效果的影响,为术中鼓膜张肌腱的处理提供参考。方法回顾性分析145例（耳）慢性化脓性中耳炎患者的临床资料,按鼓膜张肌腱完整与否及植入听骨类型的不同进行分组,其中鼓膜张肌腱完整组80例[植入部分听骨赝复物（PORP）45例,全听骨赝复物（TORP）35例],鼓膜张肌腱离断组65例（植入PORP 34例,TORP 31例）,观察并比较各组患者术后1、3个月时鼓膜形态及术后6个月时听力情况。结果术后1个月时,两组鼓膜形态无明显差别;术后3个月时,鼓膜张肌腱完整组鼓膜形态接近正常者的比例（81.25%,65/80）明显高于离断组（52.31%,34/65）。术后6个月时鼓膜张肌腱完整组（植入PORP）0.5~4kHz气导平均听阈（27.48±10.02dB HL）和气骨导差（13.57±6.36dB）均好于鼓膜张肌腱离断组（分别为32.36±9.34dB HL和25.73±7.44dB）。植入TORP的鼓膜张肌腱完整组0.5~4kHz气导平均听阈（28.76±7.14dB HL）和气骨导差（21.02±5.48dB）也均好于鼓膜张肌腱断离组（分别为39.93±5.12dB HL和31.41±6.25dB）。结论鼓膜张肌腱的完整有利于维持鼓室成形术后鼓膜的正常位置和形态,听力重建术中保留鼓膜张肌腱对术后听力恢复有明显改善作用。
Objective To study the effects of the integrit~~ of the tensor tympani muscle on the postoperative hearing recovery and the morphology of tympanic membrane, to provide the reference for the handling of the tensor tympani muscle during the operation. Methods A total of 145 cases of chronic tympanitis were grouped by the integ- rity of the tensor tympani muscle and the implanted types of biological auditory ossicles, the clinical data were ana- lyzed retrospectively. There were 80 cases in the tensor tympani muscle intact group, including 45 cases of PORP group and 35 TORP group. The tensor tympani muscle rupture group of 65 cases consisted of 34 cases of PORP group, and 31 cases of TORP group. The postoperative recovery conditions of tympanic membrane morphology, hearing threshold Ac and air--bone gap（ABG） between the ＂tensor tympani muscle intact group and the tensor tym- pant muscle rupture group were compared 1 month or 3 months, and 6 months after the operation. Results One s month after the operation, there was no significant difference in tympanic membrane morphology between the two groups. Three months after the operation, the tensor tympani muscle intact group had a higher ratio about the loca- tion and shape of tympanic membrane , closer to the normal than the tensor tympani muscle rupture group in which the ratio in the intact group was 81.25% （65/80）, while in the rupture group it was 52. 31% （34/65）. After 6 months, with the operation of PORP, the tensor tympani muscle intact group of AC value was 27.48± 10.02 dB HL, and ABG value was 13.57±6.36 dB, while the rupture group of AC value was 32. 36±9.34 dB HI.,and ABG value was 25.73±7.44 dB. With the operation of TORP,the tensor tympani muscle intact group of AC value was 28.76± 7.14 dB HL,and ABG value was 21.02±5.48 dB,while the rupture group of AC value was 39.93±5.12 dB HI., and ABG value was 31.41 ±6.25 dB. The postoperative recovery condition of the tensor tympani muscle intact group was better than those of in the rupture gr
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2014年第6期573-577,共5页
Journal of Audiology and Speech Pathology
关键词
鼓膜张肌腱
鼓膜形态
耳内镜
纯音测听
Tensor tympani muscle
Tympanic membrane morphology
Ear Endoscope
Pure tone audiometry
