Analysis Of The Relationship Between Ossicular Chain Lesions And Audiometry In Patients With Middle Ear Cholesteatoma And The Effect Of Surgery On Their Quality Of Life

Objective:(1)We used questionnaires to investigate the quality of life of patients with cholesteatoma of middle year(Cholesteatoma of middle year COME)and its influencing factors before and after surgery,and performed a cluster analysis to classify the audiogram shape before surgery to provide basis for clinical treatment and nursing.(2)This study is the first clinical application of the "Chronic Otitis Media Assessment Scale" after it was introduced and translated into Chinese.In order to further test the applicability of the Chinese version of the "Chronic Otitis Media Assessment Scale" in different regions and different hospitals,this study conducted the reliability and validity test of the scale,so as to provide a basis for the wider clinical application of the scale.(3)To explore the preoperative evaluation value of hearing in estimating the status of three Ossicles in patients with ear desease and the correlation between the degree of damage of the ossicular chain and the average air conduction,the average bone conduction,and the air-bone conduction difference.Methods:(1)This study select 109 patients who experienced operational intervention between January 2018 and December 2019 in the First Hospital of Shanxi Medical University,using the Chinese version of the Chronic Otitis Survey Scale(CCES)and the Chronic Otitis Media Evaluation Scale(CCOMOT).Compare the quality of life of patients with different clinical data before and after surgery,and use multi-factor logistic regression to investigate the causes that influencing the daily life of people who suffer from ear illness and experience surgical treatment;perform hierarchical cluster analysis on the hearing threshold of each frequency before surgery.(2)In this study,Cronbach’s α coefficient was made to estimate the credibility of the questionaire,and detection element analysis was used to test the validity.(3)This study retrospectively analyzed the pure tone audiometry results of 116 patients with acquired middle ear cholesteatoma,and divided the ossicular chain into the complete group and the interrupted group according to the intraoperative situation,and compared the average air conduction and bone conduction of the two groups of patients.Lead average value and air-bone conduction difference;scoring the ossicular chain according to the state of the three ossicles during the operation and whether they are fixed or not,to study the influence of the degree of ossicular chain disease on hearing.Results:(1)CCES showed that all dimensions and total scores after surgery were higher than those before surgery(p<0.05);the results of CCOMOT-15 showed that except for the auditory function dimensions that were unchanged from before surgery,other dimensions and total scores were higher than those before surgery(p<0.05).The results of the CCES scale show that ear discharge is an independent risk factor affecting COME patients before and after surgery(p<0.05).The score of S1 item in the patient’s preoperative CCES symptom subscale is significantly correlated with the average of preoperative ear and healthy whispering frequency(500-4000Hz);the patient’s preoperative CCOMOT’s auditory function dimension score is correlated with the affected ear and healthy whisper The average frequency of hearing frequency(500-4000Hz)has a significant correlation;the mental health dimension and total score of the scale in the preoperative CCOMOT of patients have a significant correlation with the average frequency of whispering hearing(500-4000Hz)before operation.The shape of the preoperative audiogram of the affected ear can be divided into total deafness and gradual decline.(2)The total Cronbach ’ s α coefficient of the Chinese version of the Chronic Otitis Media Assessment Scale is 0.824,and the Cronbach’s α coefficient of the three dimensions is 0.691 for ear symptoms,0.947 for auditory function,and 0.872 for mental health.The initial model fits smoothly,and the revised model suggests a good fit.(3)Compared with the complete ossicular chain group,the average air conductance and air conduction difference of the interrupted group were increased(P<0.05).As the score of the ossicular chain increases,the average air conduction,the average bone conduction,and the air-bone conduction difference also increase(P<0.05).Conclusion:(1)Surgery helps to improve the quality of life of patients;the two scales CCES and CCOMOT pay attention to the quality of life of patients from different perspectives,help doctors to understand the patient’s condition more comprehensively,and also provide nursing staff with pre-and post-operative care evaluation The content provides a valuable supplement.Cluster analysis classifies the audiogram morphology of COME patients in order to provide a basis for the surgeon to assess the status of the ossicular chain.(2)The scale has good reliability and validity,and is a reliable tool for COME patients to conduct self-assessment.The scale helps doctors to understand the patient’s condition more comprehensively,and also provides supplements for the nursing assessment content of the nursing staff before and after surgery.(3)The average value of preoperative air conduction and bone conduction in patients with middle ear cholesteatoma can be used to preliminarily judge the status of the patient’s ossicular chain.