腺样体肥大对儿童听力的影响

摘要

Objective To investigate the pathological effect of adenoid hypertrophy on auditory function of children with this kind of lesion and the rehabilitation effect of surgical therapy on their hearing level based on a clinical trial. Methods Included in this retrospective study were 140 children cases with adenoid hypertrophy, treated by adenoidectomy and grommet insertion. Auditory function of these children was tested by pure tone audiometry and tympanometry before the operation and one week after fee surgery respectively. Then, careful analysis was done on these data to evaluate the effects of adenoid hypertrophy and relative therapies on auditory function of these children. Results Among these children, 93 cases complained hearing decrease, with 20 (21.51%) showing sensorineural hearing loss at various levels in its nature as seen from audiometry. In this part of cases, tympanometry showed that 88 (165 ears) were B type of tympanogram and 5 (9 ears) were C type of this kind of curve figure. In the other part of children (47 cases) complaining no obvious feeling of auditory acuity decreasing, 25 (53.19%) were seen with hearing loss in one or both ears at various levels and in different nature as revealed from pure tone audiometry, with 30 cases (63.83%) having an abnormal tympanogram, among whom 22 showed a B type of tympanogram 8 showed a C type of curve figure. After adenoid surgery and grommet insertion, all these children were seen with their hearing improved obviously, with very significant statistical significance when compared with those data obtained preoperatively. Conclusions Adenoid hypertrophy usually cause conductive hearing loss in children, but may show sensorineural hearing loss at various levels in its nature in a part of cases. The therapy combined adenoidectomy with grommet insertion can recover their hearing effectively.%目的 观察腺样体肥大对儿童听力的影响及手术后儿童听力的恢复情况.方法 回顾性研究手术治疗的腺样体肥大患儿140例,术前行声导抗和纯音听阈检测,术后1周复查听力学检查,分析肥大腺样体对患儿听力的影响以及手术后的听力康复情况.结果 全组病例中,主诉有听力下降者93例,其内20例(21.51％)表现有不同程度的感音神经性聋；声导抗检查88例(165耳)为B型曲线,5例(9耳)为C型曲线.47例无自觉听力下降,但听力学检查结果显示29例(53.19％)存在单耳或者双耳听力下降；声导抗检查30例(63.83％)存在声导抗鼓室曲线的异常,B型曲线22例,C型曲线8例.腺样体切除并行鼓膜置管术后,所有患儿听力均明显提高,与术前相比差异有统计学意义(P＜0.05).结论 腺样体肥大可引起传导性听力下降,部分还表现感音神经性听力下降.腺样体切除联合鼓膜置管术能有效恢复患儿听力.