| Objective:By analyzing the bone conduction-induced hearing changes before and after surgery in patients with otosclerosis and the results of ti nnitus questionnaire survey,the effects of surgery on bone conduction hea ring and tinnitus were explored.Methods:A retrospective analysis of 14 patients with otosclerosis c onfirmed by intraoperative radiology and Piston artificial ossicle implantati on was performed during the 2015-2018 in our department,with ossicular chain malformations and ossicles,chain breaks,tympanosclerosis and so o n excluded.All patients were collected before and after surgery for audiol ogical data,and bone conduction-induced hearing changes before and after surgery were statistically analyzed.For patients with tinnitus preoperativel y,the visual analog scale(VAS)and tinnitus handicap inventory(THI Chi nese version)were applied to evaluates tinnitus,with VAS to assess the tinn itus loudness,and THI the impact of tinnitus on daily life,respectively.Th e subjects scored the tinnitus status before and after surgery,changes of whi ch were statistically analyzed.Results:Statistical analysises were performed on bone conduction-induced hearing changes and tinnitus changes in 14 patients.The reductions i n the air-bone conductance gap after surgery compared with preoperative at 250 Hz,500Hz,1kHz,2kHz,and 4 kHz were 31.43±15.37dB?29.29±15.42 d B?28.57±12.47 d B?13.93±15.95dB?18.93±17.56 dB,respectively,which were different(P<0.05).The bone conduction thresholds of 250 Hz,500Hz,1kHz,2 k Hz and 4k Hz after surgery compared with preoperative improved by-3.93±8.59dB?1.07±9.24dB?0.71±10.54dB?7.50±9.76dB?-10.00±14.28 d B,respectively,among which there was a difference at 2kHz and 4kHz(P<0.05),but no difference at 250 Hz,500Hz,and 1k Hz(P>0.05).VAS and THI questionnaires showed that 11 patients(79%)had tinnitus preoperativ ely.8 patients(73%)had felt tinnitus reduced or disappeared after surgery,2 cases(18%)felt no significant changes in tinnitus compared with the pre operatively,and 1 cases(9%)wera aware of worse tinnitus.VAS(tinnitus loudness)scores: The preoperative scores were 6.00±2.68 and 3.27±2.80,b etween which there was difference(P<0.05).The preoperative contralateral score was 4.18±3.06.The postoperative contralateral score was 3.73±3.20,which was no different from preoperative score(P>0.05).THI(the degree of influence of tinnitus on life)scores:The postoperative score was 48.91±28.84,which was different from the preoperative score 26.91±27.83(P<0.05).Conclusion:Stapes surgery for otosclerosis artificial ossicular implantation can effectively improve the patient's bone conduction threshold 2kHz and improve the tinnitus symptoms and can damage the patient's bone conduct ion threshold 4kHz. |
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