■慢性耳部手术后的听力结果包括复发,胆脂瘤的定位和范围,手术类型,骨成形术方法,但很少解释术中发现。本研究旨在分析术中发现对鼓膜乳突切除术后听力预测的影响。
■这是一项回顾性非随机队列研究,纳入101例通过鼓室乳突切除术治疗复发性慢性中耳炎的患者。病人的人口统计学,分析疾病复发的定位和围手术期听力结果。
■Logistic回归显示存在鼓室穿孔(p=0.036),听骨链损伤(p=0.006),与术后听力改善呈负相关。阁楼胆脂瘤与更好的术后听力相关(p=0.045)。存在鼓室穿孔(p=0.050),除了面周炎症(p=0.021)和小骨破坏(p=0.013)外,术后听力结果较差。多因素分析证实鼓室穿孔(p=0.040,F=4.401),和听骨链受累(p=0.025,F=5.249),是听力改善的一致负面预测因子,术后听力恶化与鼓室穿孔(p=0.038,F=4.465)和面神经裂开(p=0.045,F=4.160)有关。
术后翻修鼓膜切除术听力结果的比较显示,气骨间隙值显著降低,主要在低频和中频。高频下的术后听力结果不受翻修手术的影响。
UNASSIGNED: Hearing results after chronic ear surgery encompass recurrence, localization and extent of cholesteatoma, type of surgery, ossiculoplasty methods, but rarely interpret intraoperative findings. This study aimed to analyze the impact of intraoperative findings in revision tympanomastoidectomy in predicting postoperative hearing.
UNASSIGNED: This was a retrospective non-randomized cohort of 101 patients treated for recurrent chronic otitis media by tympanomastoidectomy. The patients\' demographics, localizations of disease recurrence and perioperative hearing results were analyzed.
UNASSIGNED: Logistic regression showed that presence of tympanic perforation (p=0.036), ossicular chain damage (p=0.006), were negatively associated with improved hearing postoperatively. Attic cholesteatoma was associated with better postoperative hearing (p=0.045). Presence of tympanic perforation (p=0.050), alongside perifacial localization of imflammation (p=0.021) and ossicle destruction (p=0.013) were associated with worse postoperative hearing results. Multivariate analysis confirmed that tympanic perforation (p=0.040, F=4.401), and ossicular chain involvement (p=0.025, F=5.249), were consistent negative predictors of hearing improvement, while postoperative deterioration of hearing was associated with tympanic perforation (p=0.038, F=4.465) and facial nerve dehiscence (p=0.045, F=4.160).
UNASSIGNED: Comparison of postoperative revision tympanomastoidectomy hearing outcomes revealed significant positive reductions in air-bone gap values, primarily at low and mid frequencies. Postoperative hearing results at high frequencies are not affected by revision surgery.