目的:探讨内镜下鼓室成形术和鼓室切除术对胆脂瘤患者的听力学结果是否令人满意。
方法:这是一项对83例胆脂瘤患者的回顾性研究,这些患者在2019年至2021年之间接受了内镜鼓室成形术和鼓室切除术。进行术前和术后的听力学评估。评价方法包括空气传导(AC)、骨传导(BC),和空气-骨间隙(ABG)程序。
结果:83例患者被纳入研究,所有患者均接受了内镜鼓室成形术和鼓室切除术。47例患者术后ABG≤20dB(59.49%)。测试的频率包括低频(LF),中频(MF),高频(HF),和纯音平均(PTA)。手术后所有三个听力学参数在每个频率下均显着降低(P<0.05),除BC-LF外(P>0.05)。术前、术后听力所占比例差异有统计学意义(P<0.05)。此外,AC的变化,BC,ABG与术前AC呈线性关系,BC,ABG。最后,术后ABG-PTA根据术前stapes骨上层结构的不同而表现不同(目前:15.81±11.23dB,缺失:22.94±12.20dB,P=0.009)。
结论:我们对经内镜鼓室成形术和鼓室乳突切除术的研究为胆脂瘤患者提供了完整的听力学结果。它有一个积极的手术成功率和改善AC,BC,和ABG在除BC-LF以外的每个频率。此外,由于这些程序,AC-LF和AC-MF比AC-HF改善到更大的程度。此外,线性回归分析显示,术前ABG-PTA是最有效的手术听力学指标.同样,stapes骨上层结构的术前状况被证明是听力结果最有效的解剖学指标。
OBJECTIVE: To investigated whether endoscopic tympanoplasty and
tympanomastoidectomy could present satisfying audiological outcomes for cholesteatoma patients.
METHODS: This was a retrospective study of 83 patients with cholesteatoma who underwent endoscopic tympanoplasty and
tympanomastoidectomy between 2019 and 2021. The preoperative and postoperative audiological evaluations were performed. The evaluation methods included air conduction (AC), bone conduction (BC), and air-bone gap (ABG) procedures.
RESULTS: Eighty-three patients were included in the study, all of whom underwent endoscopic tympanoplasty and
tympanomastoidectomy. Forty-seven patients presented postoperative ABG≤20 dB (59.49%). The frequencies tested included low-frequency (LF), middle-frequency (MF), high-frequency (HF), and pure-tone average (PTA). All three audiological parameters significantly decreased after surgery (P < 0.05) at every frequency, except for BC-LF (P > 0.05). There were also significant differences between the preoperative and postoperative proportions of degree of hearing (P < 0.05). Additionally, shifts in AC, BC, and ABG were linearly related to preoperative AC, BC, and ABG. Lastly, postoperative ABG-PTA presented differently depending on preoperative stapes superstructure conditions (present: 15.81 ± 11.23 dB, absent: 22.94 ± 12.20 dB, P = 0.009).
CONCLUSIONS: Our study of endoscopic tympanoplasty and
tympanomastoidectomy presented complete audiological outcomes for cholesteatoma patients. It had a positive surgery success rate and improved AC, BC, and ABG at every frequency except BC-LF. Additionally, AC-LF and AC-MF improved to a greater degree than AC-HF due to these procedures. Moreover, the linear regression analyses demonstrated that preoperative ABG-PTA was the most efficient audiological indicator for surgery. Likewise, the preoperative condition of the stapes superstructure was proved to be the most efficient anatomical indicator for hearing outcomes.