慢性鼻窦炎对中耳功能的影响——声导抗参数的改变  

Influence of chronic sinusitis on middle ear function: changes of acoustic immittance

作　　者：吉晓滨[1] 王群芳[2] 王磊[1] 杨凯[2] 

机构地区：[1]广州市第一人民医院耳鼻咽喉科,广州510180 [2]华南师范大学化学与环境学院分析测试中心,广州510006

出　　处：《中华耳科学杂志》2006年第3期223-226,共4页Chinese Journal of Otology

基　　金：广州市卫生局医药卫生科技项目基金资助(2004年)

摘　　要：目的探讨慢性鼻窦炎对中耳声导抗参数的影响。方法对53例慢性鼻窦炎病人、10例健康成人做声导抗检查,采用多状态Logistic回归模型,对慢性鼻窦炎可能影响鼓室导抗图的因素进行评价。结果(1)53例中,鼓室导抗图A型33例(62.26%),As型4例(7.55%),B型2例(3.77%),C型14例(26.42%)。(2)As、B、C型异常鼓室导抗图、鼓室峰压值、同侧镫骨肌反射、坡度在各型鼻窦炎与对照组、各型之间比较多有统计学差异。静态声顺值无差异。(3)经过对自变量逐步剔除,有2项因素,即筛窦CT分型呈硬化型和鼻窦炎分型分期较重时,影响鼓室导抗图。结论(1)随慢性鼻窦炎分型分期加重,异常鼓室导抗图、镫骨肌反射消失增多,鼓室峰压值越偏向负压,坡度值增加;静态声顺值无或稍有变化。(2)慢性鼻窦炎呈硬化型筛窦、分型分期重时,对鼓室导抗图影响更重。Objective To investigate the influence of chronic sinusitis on middle ear function. Methods This study involved 53 patients with chronic sinusitis who underwent acoustic immittance measurements. The chronic sinusitisrelated factors affecting middle ear function were evaluated with muhinomial logistic regression. Results The results were as follows： （ 1 ） Of 53 cases, 33 （62.26%） had a tympanogram of type A, 4 （7.55%） of type As, 2 （3.77%） of type B, and 14 （26.42%） of type C. （2） There were significant statistical differences between chronic sinusitis and controls and among different disease severities concerning such factors as the type As,B,C tympanogram, peak pressure, acoustic stapedius reflex and gradient. Static compliance showed no change. （3） Muhinomial logistic regression analysis showed that poorly aerated ethmoidal sinus and severe sinusitis had an influence on the tympanogram. Conclusions （1） With increasing sinusitis severity, there were also increased abnomal tympanograms and absence of acoustic stapedius reflex, a shift toward negative pressure and a higher gradient value, while static compliance showed little changes. （2） The damage of middle ear function became worse as sinusitis was more serious and the ethmoidal sinus was poorly aerated.

关 键 词：鼻窦炎 鼓室导抗图 声导抗测量 中耳功能 

分 类 号：R318.03[医药卫生—生物医学工程] R765.41[医药卫生—基础医学]