- 期刊
慢性中耳炎合併感音性聽力障礙之探討
Sensorineural Hearing Loss in Chronic Otitis Media
摘要
臨床聽力檢查發現慢性中耳炎病例常合併感音性聽力障礙（簡稱感音性聽障或骨導聽障），有關文獻國外已有報告。為了解其感音性聽障發生的原因和中耳炎所致的氣導聽力損失之相關程度和意義，本文以65例單側慢性中耳炎（unilateral chronic otitis media; COM）手術患者，平均年齡38歲，排除真正會引起內耳傷害之原因後，分成單純性、肉芽性和膽脂瘤性三組為研究對象，並以正常耳為對照組，分析討論各組平均氣導和骨導聽力損失量（500Hz、1000 Hz、2000 Hz、三者和之平均數）兩牙者間之關係。結果顯示慢性中耳炎所合併之感音性聽障，其骨導聽力損失三組中均高於正常耳，合併膽脂瘤組之平均氣導和骨導聽力損失各為66.8分貝和20.3分貝，比其他二組均為高，其發生的原因可能是受到中耳炎產生的氣導聽力損失所致的Carhart效應的影響。氣導聽力損失愈大，骨導聽力閥值也就相對地愈高，並不是內耳已受到真正的傷害。
關鍵字
無資料並列摘要
In individuals with chronic otitis media(COM), mixed hearing impairments are common, but it is unclear whether the raised bone conduction thresholds are a reflection of the pathologic process affecting the middle ear resulting in conductive defect charts of 65 patients with unilateral chronic otitis media were reviewed. These were three groups: 1) simple COM 2) COM with granulation, 3) COM with cholesteatoma. In them, the amount of sensorineural hearing loss in the third group was 20.3 dB, which was greater than the other two groups for pure-tone average. The amount of air conduction hearing loss was 66.8 Db, also the highest. In addition, the amount of sensorineural hearing loss was greater than thatof normal contralateral ears in all of three groups. The findings suggest that more severe middle ear siease may result in sensorineural hearing loss. Raised bone conduction thresholds in chronic otitis media are considerably more likely to reflect the Carhart effect, rather than disease damage to the inner ear. However, for the majority of subjects, the amount of sensorineural hearing loss was judged not to be clinically significant.