梅尼埃病-湘雅医学院课件.ppt

耳聋及其防治 中南大学湘雅二医院耳鼻咽喉-头颈外科 中南大学耳科研究所 谢鼎华 教授 内容提要 概述 听觉解剖和生理概要 分类与分级 常见病因 预防 治疗原则及方法 How the Ear Hears tructure Outer ear The pinna is a collector of sound wave vibrations that are sent through the external ear canal. Middle Ear A tympanic membrane and three tiny bones, incus, malleus and stapes, move in harmony to send the vibrations into the inner ear. Inner Ear The vibrations are changed into electrical impulses that are sent to the brain to create what we understand as “hearing.” 定义(Definition) Hearing loss, hearing impairment, deafness: Children and Adults who are deaf are those who cannot hear or understand conversational speech under normal circumstances. Deaf: Deaf is a total lack of hearing, Deafness has connotations of discrimination 耳聋分级Degrees of hearing loss 轻度耳聋 26~40dB 中度耳聋 41~55dB 中重度聋 56~70dB 重度耳聋 71~90dB 极重度耳聋 90dB 耳聋的分类 按耳聋病发的时间分类: antenatal pre- birth hearing loss inheritance 1.先天性耳聋：出生以前的耳聋 2.后天性耳聋：出生以后的耳聋 postnatal after birth hearing loss 按耳聋性质分类: 传导性耳聋（conductive hearing loss） 感音神经性耳聋（sensorineural hearing loss） 感音性（sensory deafness），或 耳蜗性（cochlear） 神经性（nervous deafness），或蜗后性（retrocochlear） 混合性聋（mixed hearing loss） 传导性耳聋 Conductive hearing loss Definition: any interruption of passage of acoustic energy between pinna and oval window. Loss of hearing that originates in the outer or middle ear. External auditory canal Eardrum Middle ear Auricle Microtia/Anotia External auditory canal Atresia/Stenosis Obstruction: Cerumen Foreign Body Osteoma/Neoplasm Infections/Otitis Externa 耳廓和外耳道疾病 鼓膜 Tympanic Membrane(Eardrum) Perforation (hole) Retraction Tympanosclerosis (stiffness) Middle Ear Absence of ossicles (middle ear bones) Stiffness of ossicles Otosclerosis Tympanosclerosis Dislocation of ossicles (trauma) Cholesteatoma Tumors 感音神经性耳聋 Sensorineural hearing loss Sensorineural - any damage to the organ of Corti or VIII nerve pathway or auditory cortex (SNHL). Sensorineural Hearing Loss