Hearing loss in perforations of the tympanic membrane
Hearing loss in perforations of the tympanic membrane
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鼓膜穿孔导致听力损失
DOI：
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发表时间：
1979
影响因子：
1.7
通讯作者：
G. V. Ramani
中科院分区：
文献类型：
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作者：
Sahar Ahmad;G. V. Ramani
摘要 对 70 名干性中央穿孔患者进行了研究，以评估听力损失情况。低频时听力损失更大，并且随着穿孔的大小而增加。踝部穿孔比非踝部穿孔导致更多的听力损失，除非穿孔涉及的鼓膜表面积少于 10%。后下象限的穿孔比前下象限的穿孔导致更多的听力损失。完整且正常振动的鼓膜的大有效表面面积在中耳变压器机制中起着重要作用。穿孔造成的表面积损失必然会导致耳聋（Mawson，1962）。听力损失的程度已在人类尸体（Békésy，1939）和猫（Bordley 和 Hardy，1937；Payne 和 Githler，1951）中进行了广泛的研究，但关于人类详细临床研究的已发表的著作并不多。大多数作者普遍认为“小穿孔”对听力影响不大，仅影响低音（Wever 和 Lawrence，1954）。 Bordley 和 Hardy (1937) 发现两个人在 256 至 4,096 Hz 频率范围内的平均损失为 12 dB。 Simpson 等人引用了 10–30 dB 损耗。 (1967)，以及 Thorburn (1971) 的语音频率损失 20-45 dB。人们普遍认为，听力损失随着穿孔的大小而增加，如果位于后下象限，则听力损失更严重（Mawson，1962；Simpson 等，1967；Thorburn，1971）。 Anthony和Harrison（1972）在对103例听力图的回顾性研究中发现，最大平均损失发生在250 Hz处，“小”穿孔（直径小于2毫米）的损失小于大穿孔的损失，接触柄的穿孔比远离柄的穿孔少，前下象限的穿孔也比后下象限的穿孔少。象限。
Abstract 70 Patients with dry central perforations have been studied to assess the hearing loss. The hearing loss is greater at the lower frequencies and increases with the size of the perforation. Malleolar perforations cause more hearing loss than the non-malleolar unless the perforation involves less than 10 per cent of the tympanic membrance surface area. Perforations of the postero-inferior quadrant cause more hearing loss than those in the antero-inferior quadrant. The large effective surgace area of an intact and normally vibrating tympanic membrane plays a major role in the middle ear transformer mechanism. The loss of this surface area by perforation is bound to cause deafness (Mawson, 1962). The degree of hearing loss has been extensively studied in human cadavers (Békésy, 1939) and in cats (Bordley and Hardy, 1937; Payne and Githler, 1951) but not much published work is available on any detailed clinical study in human beings. Most authors have generally stated that ‘small perforations’ have little effect on hearing, and only low tones are affected (Wever and Lawrence, 1954). In two individuals, Bordley and Hardy (1937) found average losses of 12 dB over frequencies ranging from 256 to 4,096 Hz. 10–30 dB loss is quoted by Simpson et al. (1967), and 20–45 dB loss in the speech frequencies by Thorburn (1971). It has been a general view that the hearing loss increases with the size of the perforation, more so it if is located in the postero-inferior quadrant (Mawson, 1962; Simpson et al., 1967; Thorburn, 1971). In a retrospective study of audiograms in 103 cases, Anthony and Harrison (1972) found that the maximum average loss occurred at 250 Hz., the loss being less in ‘small’ perforations (less than 2 mm. diameter) than in large ones, less in perforations touching the manubrium than in those away from it, and also less in perforations of the antero-inferior quadrant than in those in the postero-inferior quadrant.