颞骨CT正常儿童1kHz鼓室声导纳特征  

The Study of 1kHz Infants Tympanometric Admittance Norms with Normal Temporal Bone CT

作　　者：吕静[1] 莫玲燕[1] 刘辉[1] 陈雪静[1] 卞迁[1] 孙玉兰[1] 陈静[1] 张帆[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京市耳鼻咽喉科学研究所耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100005

出　　处：《听力学及言语疾病杂志》2011年第4期315-319,共5页Journal of Audiology and Speech Pathology

基　　金：国家"十一五"科技支撑计划基金(2007BAI181312);科技部国际合作课题(2009DFA32200);北京市卫生系统高层次卫生技术人才培养基金(2009-3-29)联合资助

摘　　要：目的探讨颞骨CT正常儿童1 kHz鼓室声导纳的特点。方法双耳或单耳颞骨薄层CT示外、中、内耳结构均正常的儿童93例（162耳）,其中,男58例（97耳）,女35例（65耳）,年龄2~66月龄（中位数19月）,采用GSI-Tympstar中耳分析仪对其行1 kHz探测音鼓室导纳测试,记录鼓室导纳图形及峰导纳值（tympanometricpeak admittance,Ypeak）、鼓室图峰压（tympanometric peak pressure,TPP）、负尾部补偿导纳值（negative tail com-pensated admittance,Comp Y-400,为Ypeak值与-400 daPa处的导纳值之差）等指标的均值、标准差及95%可信区间,并分析耳别、性别及年龄对上述各指标的影响。结果①鼓室导纳图形态：单峰型149耳（91.98%,149/162）,双峰型3耳（1.85%,3/162）,平坦型5耳（3.09%,5/162）,其它类型5耳（3.09%,5/162）。②各指标均值、标准差及95%可信区间分别为：Ypeak：4.13±1.42 mmHo,2.12~7.96 mmHo,TPP：29.56±74.92 daPa,-186.75~142.63 daPa,CompY-400：2.11±1.14 mmHo,0.89~5.25 mmHo。③不同耳别间Ypeak、TPP及CompY-400的差异无统计学意义（P〉0.05）;④不同性别间Ypeak和CompY-400的差异有统计学意义（男性高于女性,P=0.001,P=0.000）,但TPP的性别间差异无统计学意义;⑤不同年龄组间Ypeak、CompY-400及TPP的差异有统计学意义,0~6月龄婴儿Ypeak及CompY-400均值显著低于其他年龄组。结论①颞骨CT正常儿童1 kHz鼓室导纳图多数为单峰型,但其Ypeak、TPP、CompY-400的95%可信区间范围较大。②男性的Ypeak显著高于女性;Ypeak和CompY-400随着年龄的增长而增长,Ypeak在12月龄、CompY-400在6月龄时此增长趋于缓和;TPP随年龄变化的特点不明显。Objective To explore the characteristics of 1 kHz tympanometry of children with normal middle ear evidence by CT,and to provide a clinical reference for detecting middle ear pathology.Methods This study involved 93 infants（162 ears）,58 boys（97 ears）,35 girls（65 ears） with normal CT results of outer,middle and inner ear structure in both ears or at least one ear.Their age ranged from 2 to 66 months（median 19 months old）.1 kHz tympanogram pattern,mean value,standard deviation and 95% confidential interval were recorded as the variable to observe potential impacts on tympanometric peak admittance（Ypeak）,tympanometric peak pressure（TPP） and negative tail compensated admittance（CompY-400,the difference between tympanometric peak admittance and admittance at Y-400）.The ears,genders and age were also analized.Results ①Patterns： The results showed single-peaked tympanograms for 149 ears（91.98%,149/162）,double-peaked 3 ears（1.85%,3/162）,flat tympa nograms 5 ears（3.09%,5/162）,and other type of tympanograms 5 ears（3.09%,5/162）.②Mean value： The results showed that standard deviation and 95% confidential interval were 4.13±1.42 mmHo and 2.12~7.96 ④ There was significant difference between boys and girls at Ypeak and CompY-400,but no significant difference at TPP.Boys had significant higher mean value of Ypeak and CompY-400 than girls.⑤There were significant differences among ages at Ypeak,CompY-400 and TPP.Further pair comparison studies found that 0~6 month infants had the lowest Ypeak and CompY-400 mean value than other age groups.⑥The interactions among ear,gender and age had no significant difference at any of these factors.Conclusion ①For 1 kHz tympanometry,children with normal middle ear evidence by CT,Ypeak,TPP,and CompY-400 ranges from 2.12~7.96 mmHo,-186.75~142.63 daPa and 0.89~5.25 mmHo respectively.②1 kHz tympanometry for children with normal middle ear were mostly single-peaked,but the 95% confidential interval of the Ypeak,Tpp,CompY-400 is wider.Boys

关 键 词：颞骨薄层CT 儿童 正常值 鼓室导纳测试 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]