정상 고막과 기도골도차를 가지는 비외상성 난청의 임상양상과 측두골 Computed Tomography 분석
The Clinical Manifestation and Temporal Bone Computed Tomography Findings of Non-Traumatic Hearing Loss With Air-Bone Gap and Intact Tympanic Membrane
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Background and Objectives This study aimed to investigate the causes, clinical manifes-tations, temporal bone CT findings, and audiologic results of outpatients with non-traumatichearing loss with air-bone gaps and intact tympanic membranes. Subjects and Method The medical records from 2014 to 2022 of 66 patients (77 ears) withnormal tympanic membranes but who had the air-bone gap of more than 20 dB over two con-secutive frequencies were reviewed. Results The mean age of the patients was 46.8±17.0 years old. The mean air-bone gap was24.8±10.3 dB. Of the 77 ears (66 patients) studied, 10 ears were surgically diagnosed with oto-sclerosis (6 ears), ossicular discontinuity (2 ears), superior semicircular canal dehiscence (1 ear),and unknown etiology (1 ear). Additionally, 29 more ears (28 patients) were clinically diagnosedwith silent otitis media (7 ears), otosclerosis (5 ears), thickened tympanic membrane (5 eras),E-tube dysfunction (4 ears), ossicular anomaly (4 ears), semicircular canal dysplasia (2 ears),and endolymphatic hydrops (2 ears). Temporal bone CT images showed normal findings in 33ears (54.1%) and abnormal findings in 28 ears (45.9%). Patients with abnormal CT findingshad a poorer speech discrimination score than those with normal findings ( p<0.05). The air-bone gap was significantly decreased postoperatively from 30.5±12.7 dB to 6.4±4.0 dB, witha tendency to decrease greater at a low frequency than at a high frequency. Conclusion Among patients with air-bone gap and intact tympanic membrane, otosclerosiswas the most commonly confirmed diagnosis through surgery, while silent otitis media wasthe most frequently observed diagnosis based on clinical evaluations.
Abstract
Background and Objectives This study aimed to investigate the causes, clinical manifes-tations, temporal bone CT findings, and audiologic results of outpatients with non-traumatichearing loss with air-bone gaps and intact tympanic membranes. Subjects and Method The medical records from 2014 to 2022 of 66 patients (77 ears) withnormal tympanic membranes but who had the air-bone gap of more than 20 dB over two con-secutive frequencies were reviewed. Results The mean age of the patients was 46.8±17.0 years old. The mean air-bone gap was24.8±10.3 dB. Of the 77 ears (66 patients) studied, 10 ears were surgically diagnosed with oto-sclerosis (6 ears), ossicular discontinuity (2 ears), superior semicircular canal dehiscence (1 ear),and unknown etiology (1 ear). Additionally, 29 more ears (28 patients) were clinically diagnosedwith silent otitis media (7 ears), otosclerosis (5 ears), thickened tympanic membrane (5 eras),E-tube dysfunction (4 ears), ossicular anomaly (4 ears), semicircular canal dysplasia (2 ears),and endolymphatic hydrops (2 ears). Temporal bone CT images showed normal findings in 33ears (54.1%) and abnormal findings in 28 ears (45.9%). Patients with abnormal CT findingshad a poorer speech discrimination score than those with normal findings ( p<0.05). The air-bone gap was significantly decreased postoperatively from 30.5±12.7 dB to 6.4±4.0 dB, witha tendency to decrease greater at a low frequency than at a high frequency. Conclusion Among patients with air-bone gap and intact tympanic membrane, otosclerosiswas the most commonly confirmed diagnosis through surgery, while silent otitis media wasthe most frequently observed diagnosis based on clinical evaluations.
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