年齡與鼓膜穿孔大小對第一型鼓室成形術聽力改善之影響

背景：第一型鼓室成形術目的在於修補鼓膜，減少長期慢性之發炎，達成乾燥耳的目標。然而聽力改善對某些人而言，也有助於提升日常生活品質。本研究的目的在於探討年齡與鼓膜穿孔大小，是否會影響第一型鼓室成形術術後的聽力及氣骨導差改善程度。方法：本研究收集臺大醫院耳鼻喉部在1999年7月到2011年5月間，由單一資深主治醫師負責的第一型鼓室成形術的病例做病歷回顧。紀錄病人年齡與鼓膜穿孔大小，術前及術後聽力閾值及氣骨導差，並統計年齡及穿孔大小與聽力閾值及氣骨導差改善程度之關係。結果：統計期間共157耳納入研究，平均年齡43歲，術後鼓膜完整的有113耳，手術成功率72%(113/157)。針對術後鼓膜完整且有完整聽力檢查者進行統計分析，術前聽力閾值平均41.8 dB，術後32.4 dB，改善9.4 dB；術前氣骨導差平均24.7 dB，術後18.1 dB，改善6.6 dB。手術後聽力及氣骨導差的改善程度，與年齡之間的相關性未達統計上的顯著意義，與鼓膜穿孔大小呈低度正相關。結論：本研究發現，針對第一型鼓室成形術，在鼓膜修補成功的情形下，病人術後聽力及氣骨導差有顯著進步。而聽力及氣骨導差的改善程度，與年齡之間的相關性未達統計上的顯著意義，而與鼓膜穿孔大小呈低度正相關。

關鍵字

年齡；鼓膜穿孔；鼓室成形術；聽力閾值；氣骨導差

並列摘要

BACKGROUND: The goal of type 1 tympanoplasty is to restore an intact eardrum, to reduce chronic inflammation, and thus to restore a dry ear. The improvement in hearing, to some people, also brings a better life quality. This research aims to clarify whether age and the size of eardrum perforation will influence the effects of type 1 tympanoplasty on the improvement in hearing and air-bone gap. METHODS: In this chart review study of patients who received type 1 tympanoplasty performed by the same one senior surgeon in Department of otolaryngology, National Taiwan University Hospital during the period from July 1999 to May 2011, we noted down the age of patients, the size of their eardrum perforation, their hearing threshold and air-bone gap before and after type 1 tympanoplasty. The relationships of age and perforation size to hearing and air-bone gap improvement were analyzed. RESULTS: A total of 157 ears were included in the study. The average age of patients was 43-year-old. Among them, 113 intact eardrums were restored after type 1 tympanoplasty, giving a successful rate of 72% (113/157). The postoperative mean hearing threshold was 32.5 dB, improving 9.4 dB from a preoperative mean hearing threshold of 41.8 dB. The preoperative mean air-bone gap of 24.7 dB has improved 6.6 dB to a postoperative mean air-bone threshold of 18.1 dB. No statistically significant correlation was found between the age and the improvement of hearing and air-bone gap, but the improvement of hearing and air-bone gap showed weak positive correlation with the perforation size. CONCLUSIONS: In the cases of successful eardrum repair with type 1 tympanoplasty, patients’ hearing threshold and air-bone gap had significantly improved. Moreover, the improvement in hearing and air-bone gap had no statistically significant correlation with age, but showed weak positive correlation with the perforation size.

並列關鍵字

age ； eardrum perforation ； tympanoplasty ； hearing threshold ； air-bone gap

國際替代計量

年齡與鼓膜穿孔大小對第一型鼓室成形術聽力改善之影響

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