對側耳聽力狀況與鼓室形成術

施行鼓室成形術時，對側耳的聽力狀況是一項重要的參考指標，但在文獻上卻罕有人就其討論。本文針對146例接受鼓室成形術之慢性中耳炎病例，依據術前對側耳之聽力水準分組，分析手術側耳之術前聽力情形、膽脂瘤之相關、手術術型、及術後手術耳聽力之增益。發現術前對側耳有24%聽力為中重度損失，而且其手耳之術前聽力一樣不佳。相對於對側耳聽力較佳者，接受鼓室成形術第一型的比例較高，中重度聽力損失者則有一半接受第三型或第四型手術。而術後手術耳聽力改善情形以接受第一型較好，平均增加1.45分貝，第三型較差，平均只增加5.6分貝。對側耳聽力中重度損失者，手術耳後聽力改善，未達社會適應水準。因此在對較佳聽力better hearing) 之一耳施行手術時應格外小心，以保障病人術後之聽力，改善其社會適應能力。

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並列摘要

The contralateral hearing level of the operated ear is closely related to its preoperative hearing level, and is an important index to the success of tympanoplasty. We analysed 146 cases of chronic otitis media who had received tympanoplasty by the same surgeon at Kaohsiung Medical College Hospital. From the results of pure tone audiometry, we divided the hearing acuity into the following 5 categories: normal hearing, mild hearing loss, moderate hearing loss, severe hearing loss, and deafness. Referring to the categories of contralateral hearing, we discuss the preoperative hearing level of the operated ear, the occurrence of cholesteatoma, the type of the tympanoplasty, and the auditory gain of the operation. Wheile 23.97% cases had moderate or severe loss of contralateral hearing, their hearing acuity of the operated ear was also poor. Most of cases with normal contralateral hearing received type Ⅰtympanoplasty. Compared to the above group, half of the cases with moderate or severe contralateral hearing loss received type Ⅲ or type Ⅳ operations to reconstruct the ossicle chain. Though the type ⅠCases had more hearing gains than the type Ⅲ cases, those with moderate contralateral hearing loss had good results from the type Ⅲ tympanoplasty. We also found the cases with cholesteatoma in the operated ear had better contralateral hearing in the contralateral ear than the cases without cholesteatoma. The decision to perform tympanoplasty in cases of the better hearing ear with poor contralateral hearing should be very carefully made so as to improve the postoperative social life of the patients.

並列關鍵字

tympanoplastyl ； contralateral hearing ； better hearing

國際替代計量

對側耳聽力狀況與鼓室形成術

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