Clinical Analysis Of Postoperative Hearing Change On60Patients With Chronic Suppurative Otitis Media

Objective: To investigate the different influence of the post-hearing changesafter surgical teatment in patients with choronic suppurative otitis media.Methods:60patients of COSM with medical record in ENT department in theSecond Affiliated Hospital of Dalian Medical University Department from March2012-October2013were retrospectively studied.28cases of male,32cases of female,age16to64years old, average39.8813.21years. Course in8months to60years.All patients had recurrent ear pus and hearing loss in performance, both single-eardisease. All patients before the operation line of such as PTA, acoustic impedance, themiddle ear CT exmination. According to the codition to give tympanotomy andmyringoplasty or radical mastoidectomy and tympanoplasty or radical mastoidectomyand tympanoplasty and ossicular reconstruction. Patients were given PTAexamination after6months, Hearing assessment was based on the PTA result and0.5kHz,1kHz,2kHz were averaged for both air conduction and bone conduction.High frequency bone coduction was estimated by the average value of2kHz,4kHz,6kHz,8kHz. We use Pre-AC(Post-AC) and Pre-BC(Post-BC) forcalculatingPre-ABG(Post-ABG), all values includedAC, BC, ABG and high frequency bonecoduction were exhibitted as Mean SD. SPSS17.0statistical package was chose toanalyse the data, or Kruskal-Wallis test to compare the results, set the inspection levelas α=0.05, P<0.05was thought to have differences with a statistical significance. Results: Patients were followed up6months,3cases of tiny membraneperforation were found, tympanic membrane transplantation survival rate was92%,1case which received PORP implantation discharged the titanic ossicular because ofinfection. The ears dried between7and12weeks postoperative.12cases complainedof tinnitus preoperative,14cases were found tinnitus postopative,9casesdisappeared.Post-AC for29cases received tympanotomy and myringoplasty was20.4510.74dB, reduced by17.830.80dB; ABG was19.9410.20dB, changed by6.780.26dB, high frequency bone conduction changed by1.410.66dB.Post-AC for17cases received radical mastoidectomy and tympanoplasty was31.4717.43dB, improved by11.083.25dB; ABG was17.359.01dB, changed by14.221.47dB.Post-AC for14cases received radical mastoidectomy and tympanoplasty andossicular reconstruction（titanic ossicular replacement）was46.789.19dB, improvedby11.550.28dB; ABG was15.1813.82dB, changed by17.201.25dB.In all patients, Post-ABG for pure tympanic membrane repair of patients wasbetween10and20dB, the other two were main at about between20and30dB;Postoperative hearing increase is accounted for76.67%, no improve16.67%,deterioration6.67%.21cases who underwent the mastoid radical surgery withpostoperative high frequency bone conduction hearing dropped significantly.Conclusion: The surgical treatment of CSOM is the effective measure to get ridof the focue and improve the patients’ hearing. There are many influence factors inpatients with CSOM, include surgical procedures, the degree of lesion, the material ofossicular reconstruction, etc. Iatrogenic electric drill noise can cause sensorineuralhearing loss.