摘要
目的探讨耳硬化症患者镫骨底板开窗+人工镫骨植入术后耳鸣改变情况和术后耳鸣疗效的影响因素。方法分析行镫骨底板开窗+人工镫骨植入术的耳硬化症伴耳鸣症状的54例患者(65耳)的术前及术后1个月、术后6个月听力检查结果,包括术前耳鸣残疾量表(THI)、术后1个月、术后6个月THI和临床总体印象量表(CGI-S)评分并进行比较。结果术前低频(<1 kHz)耳鸣共31耳(47.7%),中频(1~4 kHz)14耳(21.5%),高频(≥4kHz)20耳(30.8%)。术后1个月48耳(73.8%)耳鸣改善(耳鸣完全消失及耳鸣减轻),16耳(24.6%)耳鸣无变化,1耳(1.5%)耳鸣较术前加重;术后6个月50耳(76.9%)耳鸣改善,13耳(20.0%)耳鸣无变化,1耳(1.5%)耳鸣较术前加重。低频耳鸣、中频耳鸣组的术后耳鸣改善效果较高频耳鸣组更好(P<0.001和P=0.013)。术后1个月主观耳鸣变化情况如气导、骨导阈值变化与术前比较差异均有统计学意义(P均<0.001),但气骨导差比较差异无统计学意义(P>0.05)。结论耳硬化症患者行镫骨底板开窗+人工镫骨植入术不仅可以明显改善听力水平,同时也能较好地改善大多数患者的耳鸣症状,术前低、中频耳鸣患者较高频耳鸣患者耳鸣改善更明显。
Objective To analyze the changes in tinnitus after stapedotomy combined with artificial stapes implantation,and further explore the factors influencing the efficacy of postoperative tinnitus in patients with otosclerosis.Methods A total of 54 patients(65 ears)with otosclerosis complicated with tinnitus symptoms who underwent stapedotomy combined with artificial stapes implantation were enrolled.The hearing test results of all patients before surgery,1 and 6 months after surgery were recorded.The scores of Tinnitus Handicap Inventory(THI)and Clinical Global Impression Scale(CGI-S)before surgery,1 and 6 months after surgery were compared.Results Before surgery,low-frequency(<1 kHz)tinnitus was observed in 31 ears(47.7%),medium-frequency(1-4 kHz)tinnitus in 14 ears(21.5%),and high-frequency(≥4 kHz)tinnitus in 20 ears(30.8%).At 1 month after surgery,tinnitus symptom was alleviated in 48 ears(73.8%)(complete healing and mitigation of tinnitus),no changes in 16 ears(24.6%),and tinnitus symptom was aggravated in 1 ear(1.5%).At 6 months after surgery,tinnitus symptom was eased in 50 ears(76.9%),no changes in 13 ears(20.0%),and tinnitus symptom was aggravated in 1 ear(1.5%).Patients with low-and medium-frequency tinnitus obtained more significant improvement in tinnitus compared with their counterparts with high-frequency tinnitus(P<0.001 and P=0.013).At postoperative 1 month,the changes in subjective tinnitus,such as the average air conduction and bone conduction thresholds significantly differed from those before surgery(all P<0.001),whereas there was no statistical significance in air-bone gap(P>0.05).Conclusions Stapedotomy combined with artificial stapes implantation can not only restore the hearing of patients with otosclerosis,but also mitigate the tinnitus symptoms in most patients.Patients with low-and medium-frequency tinnitus before surgery can obtain more significant improvements in tinnitus after surgery than those with high-frequency tinnitus.
作者
田家旺
李永奇
Tian Jiawang;Li Yongqi(Department of Otorhinolaryngology Head and Neck Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)
出处
《新医学》
CAS
2024年第3期233-237,共5页
Journal of New Medicine
