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目的:初步研究成人分泌性中耳炎(OME)所致的骨导听力下降。方法:2009-03-2010-02间收集的成人OME 50例,比较51耳中耳穿刺抽液前、后骨导听阈变化;单耳发病对耳健康者,将患耳穿刺前骨导听阈和健耳进行比较24例,穿刺后骨导与健耳比较22例,痊愈后骨导与健耳比较9例,痊愈后高频、超高频与健耳比较4例。结果:中耳穿刺抽出中耳积液后骨导听力在各频(0.5、1.0、2.04、.0 kHz)均明显提高,4.0 kHz最显著;单耳发病对耳健康者2耳比较,穿刺前患耳骨导听力(0.5~4.0 kHz)下降,穿刺和痊愈后多数可以恢复至健耳水平;4例中有3例患耳痊愈后的高频、超高频(8、10、121、6 kHz)与健耳相比听力下降。结论:OME的中耳积液和内耳损伤均可引起骨导听力下降,但0.5~4.0 kHz频区的骨导听力下降多由中耳积液所致,内耳损伤早期主要表现为高频、超高频区的听力下降,随病程延长可向较低频区发展。
Objective: To study the decrease of bone conduction hearing induced by OME in adults. METHODS: Fifty adult OME patients were collected from March 2009 to February 2010 to compare the changes of the bone conduction threshold before and after the ear was punctured in 51 ears. Compared with the healthy ears, 24 cases were compared. There were 22 cases of bone conduction and healthy ears after puncture, 9 cases of bone conduction and healthy ears were recovered, and 4 cases were cured after high frequency and ultra-high frequency. Results: The bone conduction hearing after middle ear puncture was significantly increased at each frequency (0.5,1.0,2.04, .0 kHz), most notably at 4.0 kHz. Hearing-induced hearing loss (0.5-4.0 kHz) decreased most of the time after punctures and healed. In 4 cases, 3 cases recovered from high frequency and ultra-high frequency (8,10,121,6) kHz) Hearing loss compared to healthy ears. CONCLUSIONS: Both middle ear effusion and inner ear injury of OME can cause decreased bone conduction hearing. However, the decrease of bone conduction hearing in the 0.5-4.0 kHz region is mainly caused by effusion of the middle ear. The early damage of the inner ear mainly manifests as high frequency, Hearing loss in high frequency area, with the duration of the disease can be developed to lower frequency.