Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (1): 9-14.doi: 10.6040/j.issn.1673-3770.1.2019.063

• Clinical Report • Previous Articles     Next Articles

Analysis of clinical characteristics and prognosis of post traumatic hearing loss

Yujing DING1,2(),Lan LAN1(),Qiuju WANG1,Fei JI1,Fen XIONG1,Linyi XIE1,Haina DING1,Yin XIA2,*(),Hui ZHAO1,*()   

  1. 1. ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital / National Clinical Research Center for Otolaryngologic Diseases / Key Lab of Hearing Science, Ministry of Education / Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing 100853, China
    2. Department of Otolaryngology Head and Neck Surgery, Beijing Tian tan Hospital, Capital Medical University, Beijing 100070, China
  • Received:2019-07-24 Online:2020-01-20 Published:2020-03-06
  • Contact: Yin XIA,Hui ZHAO E-mail:dyjing0830@126.com;ll-301@263.net;xiayin3@163.com;huizhao@yeah.net
  • Supported by:
    国家重点研发计划(2017YFA0104702)

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Abstract: Objective

The clinical characteristics and prognosis of post traumatic hearing loss were retrospectively evaluated to aid further diagnosis, medical evaluation, early identification, and effective treatment.

Methods

We recruited 84 patients (96 ears) and obtained their clinical examination findings, hearing test results, and audiograms from a single-institution otolaryngology service with comparative data generated from their first and follow-up visits.

Results

Among all the recruited patients, 34 ears (35.4%) had normal hearing, while 62 ears (64.6%) had hearing loss after trauma, at their first visit. Among 62 ears with hearing loss, 33 ears (53.2%) had conductive hearing loss, 25 ears (40.3%) had sensorineural hearing loss, and four ears (6.5%) had a mixture of conductive and sensorineural hearing loss. At the follow-up visit, the air conduction threshold of ears with conductive hearing loss had significantly decreased from 45.77±4.28 dB HL to 34.48±4.53 dB HL (t=2.906, P < 0.05), while the bone conduction threshold decreased from 23.45±2.31 dB HL to 19.63±2.20 dB HL (t=2.906, P < 0.05). However, no significant differences between the first and follow-up visits were observed in ears with sensorineural hearing loss or ears with mixed hearing loss. Of all the 96 ears, 39 (40.6%) had intact tympanic membrane, while 57 (59.4%) had traumatic tympanic membrane perforation. At follow-up, 40 ears (70.2%) with traumatic tympanic membrane perforation had healed spontaneously, while 12 ears (21.1%) had healed after tympanoplasty. However, five ears (8.8%) did not heal. Among the ears that spontaneously healed, 83.0% had grade Ⅰ and 16.7% had grade Ⅱ tympanic membrane perforation. Ears with grade Ⅲ and grade Ⅳ tympanic membrane perforations did not heal spontaneously.

Conclusions

Hearing impairment is a common clinical presentation in patients with traumatic injury. In most patients, this manifests as conductive hearing loss, while severely affected patients may have sensorineural or mixed hearing loss. Patients with conductive hearing loss have a favorable prognosis, while patients with sensorineural or mixed hearing loss have a poor prognosis. Trauma could cause different degrees of tympanic membrane perforation. With gradually aggravated tympanic membrane perforation, the spontaneous healing rate decreases. Therefore, for patients with large tympanic membrane perforations, which rarely heal spontaneously, tympanoplasty is warranted.

Key words: Trauma, Hearing loss, Tympanic membrane perforation, Prognosis

CLC Number: 

  • R764

Table 1

Hearing recovery in 96 ears in patients withtraumatic hearing loss"

听力损失程度
dBHL		 初诊
[ n(%)]		 复诊
[ n(%)]
正常(0~25) 34(35.4) 56(58.3)
轻度(26~40) 29(30.2) 12(12.5)
中度(41~60) 12(12.5) 14(14.6)
重度(61~80) 10(10.4) 3(3.1)
极重度(＞80) 11(11.5) 11(11.5)
合计 96(100.0) 96(100.0)

Table 2

Hearing outcomes in patients with different types of hearing loss"

听力损失类型 平均听阈(dB HL) t P
初诊 复诊
传导性聋气导 45.77±4.28 34.48±4.53 2.906 0.007
传导性聋骨导 23.45±2.31 19.63±2.20 2.329 0.026
感音神经性聋气导 75.75±5.19 69.18±5.81 1.408 0.172
混合性聋气导 66.25±3.31 53.43±11.63 1.188 0.320
混合性聋骨导 32.38±4.03 24.14±1.90 1.805 0.169

Fig.1

Hearing outcomes in patients with conductive deafness"

Table 3

Tympanic membrane perforation and its outcome"

鼓膜穿孔范围(%) 自愈 术后愈合 未愈
0~25 39 6 2
25~50 1 3 2
50~75 0 3 0
75~100 0 0 1
合计 40 12 5

Fig.2

Healing process of tympanic membrane perforation"

Table 4

Relationship between tympanic membrane perforation and hearing recovery in patients with tympanic membrane perforation with conductive hearing loss"

纯音测听 平均听阈(dB HL) t P
愈合前 愈合后
气导听阈 38.16±3.34 25.06±2.43 3.456 0.002
骨导听阈 18.35±1.70 14.91±1.34 2.007 0.056
气骨导差 19.81±2.40 10.15±1.96 2.903 0.008
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