| Research Background:Otitis media is an inflammatory lesion involving the middle ear(including tympanum,tympanum tube and tympanum sinus,etc.),which can be divided into suppurative otitis media and non-suppurative otitis media according to the pathological conditions,and its incidence is related to age,gender,immunity,environment and other factors.Chronic otitis media is more due to acute suppurative otitis media caused by improper or not timely treatment,patients often tinnitus,headache,ear discharge and other symptoms,serious can cause deafness,affect the quality of life of patients and physical and mental health.Tinnitus is an abnormal auditory cognition in the absence of external sound stimulation.Long-term persistent tinnitus not only affects the quality of life,but also causes a variety of psychological symptoms such as anxiety,depression,irritability,memory loss,distraction,hearing and perception disorder,and sleep disorder.Therefore,how to effectively treat chronic otitis media with tinnitus has been an important topic of clinical research.Objective:To investigate the surgical effect of tympanoplasty in the treatment of chronic otitis media with tinnitus,and to analyze the related factors affecting the outcome of tinnitus,so as to provide a basis for clinical treatment.Methods:Selected 124 patients with chronic otitis media admitted to the department of otolaryngology of our hospital from January 2017 to October 2018 as the research objects,and divided them into tinnitus group(64 cases)and non-tinnitus group(60 cases)according to whether they had tinnitus before surgery,and all of them were treated with tympanoplasty.The improvement of tinnitus symptoms was recorded preoperatively and 6 months after surgery.Tinnitus disability scale(THI)was used to evaluate the improvement of tinnitus symptoms after treatment.AURIC AL Plus audiometer was used for pure tone test,and the hearing changes were statistically analyzed.Visual analogue scale(VAS)was used for subjective evaluation of tinnitus symptoms.To analyze the relationship between the hearing of bone conduction and the difference of qi and bone conduction before operation and the outcome of tinnitus.The hearing improvement before and after treatment was compared between the tinnitus group and the non-tinnitus group.To analyze the relationship between types of chronic otitis media,duration of tinnitus(< 3 years or 3 years),use of electric drill and improvement of tinnitus.Results:After surgical treatment,the severity of tinnitus was reduced compared with that before treatment(P < 0.05),THI scale's functional,emotional and severity score was lower than that before treatment(P< 0.05),and the mean airway audiometric threshold,bone audiometric threshold,poor airway and VAS score were significantly decreased compared with that before surgery(P< 0.05).There was no significant difference in THI scores between the bone conduction threshold < 25 dBHL group and the bone conduction threshold > 25 dBHL group before and after surgery(P> 0.05).Postoperative bone conduction threshold < 25 dBHL group and bone conduction threshold > VAS score in 25 dBHL group were both lower than those before surgery,and the differences were statistically significant(P< 0.05).There was no statistically significant difference in THI and VAS scores before and after surgery in patients with PBHL < 15 BHL before and after surgery(P> 0.05),but THI and VAS scores before and after surgery in patients with PBHL < 15 BHL were statistically significant(P< 0.05).Before surgery two groups of the Pre-AC,Pre-BC,Pre-compare ABG level differences had no statistical significance(P> 0.05),postoperative 6 months Post-AC,the Post-BC,Post-ABG than preoperative declined significantly,the difference was statistically significant(P< 0.05),but there was no statistically significant difference between groups(P> 0.05)in the patients after the operation,effective treatment(tinnitus)50 cases,14 cases,the effective rate was 78.13%.The type of otitis media disease,the course of tinnitus and whether the electric drill was used during the operation had no significant effect on the prognosis of tinnitus(P> 0.05).Conclusions:Tympanoplasty for chronic otitis media with tinnitus can effectively alleviate the symptoms of tinnitus and improve the level of hearing;The classification of chronic otitis media,the course of tinnitus,and whether or not to use an electric drill had no correlation with the prognosis of tinnitus.Poor preoperative airbone conduction is an important factor to predict the outcome of tinnitus in patients with chronic otitis media and tinnitus. |
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