婴幼儿高频探测音鼓室导抗测试与中耳CT测试结果的比较  

Comparison of results of high-frequency probe tone tympanometry and middle ear CT scanning

作　　者：刘志奇[1] 刘立思[2] 杨琨[3] 

机构地区：[1]湖北省妇女儿童医院耳鼻喉科 [2]华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科,湖北武汉430070 [3]武汉大学人民医院耳鼻咽喉头颈外科

出　　处：《中国妇幼保健》2012年第17期2620-2622,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨1 000Hz探测音鼓室导抗测试在婴幼儿分泌性中耳炎患者中的诊断价值。方法:选择2007年9月～2010年3月间49例患儿,对患儿行颞骨螺旋CT扫描和高频探测音鼓室导抗测试,以CT检查结果为标准,比较1 000 Hz探测音鼓室导抗测试的诊断结果与CT检测结果的一致性,计算Kappa值(κ值)。结果:49名患儿98耳中,CT检查显示中耳正常44耳,有中耳积液54耳。CT检查显示,正常的44耳中,43耳鼓室导抗图为单峰型(97.67%),1耳为平坦无峰型(2.33%);在CT检查显示有中耳积液54耳中,53耳为平坦无峰型(98.15%),1耳为单峰型(1.85%);1 000 Hz探测音鼓室导抗测试与CT测试结果的诊断符合率较高,κ=0.945。CT检查显示正常的44耳中,其1 000 Hz探测音鼓室导抗测试结果分别为:外耳道容积(Vec)(0.58±0.11)ml;峰声导纳值(Y)(0.60±0.25)mmho;鼓室导抗图宽度(TW)(132.48±31.36)dapa;峰声导纳值时外耳道压力(TPP)(20.47±35.01)dapa。结论:1 000Hz探测音鼓室导抗测试与颞骨螺旋CT测试结果有较高的诊断一致性。在临床实践中,可以用1 000Hz探测音鼓室导抗测试的正常值作为标准来判断婴幼儿分泌性中耳炎有无鼓室积液。Objective： To explore the value of 1 000 Hz probe tone tympanometry in diagnosis of infantile secretory tympanitis. Methods： Forty - nine infants were selected from September 2007 to March 2010, then spiral CT scanning of temporal bone and high - frequency probe tone tympanometry were conducted, the results of CT scanning were designed as diagnostic criterion, the consistency of 1 000 Hz probe tone tympanometry and CT scanning was compared, Kappa value （K value） was calculated. Results： Among 49 infants （98 ears） , 44 ears were found with normal middle ear by CT scanning, and 54 ears were found with middle ear effusion. The results of CT scanning showed that among 44 normal ears, the tympanogram of 43 ears （97. 67% ） was single -peak type, and the tympanogram of one ear （2. 33% ） was flat type; among 54 ears with middle ear effusion, the tympanogram of 53 ears （98. 15% ） was flat type, and the tympano- gram of one ear （ 1.85% ） was single - peak type. The diagnostic coincidence rate of 1 000 Hz probe tone tympanometry and CT scanning was high, K = 0. 945. Among 44 normal ears displayed by CT scanning, the results of 1 000 Hz probe tone tympanometry could be listed as follows： external auditory canal volume （Vec） ： （0. 58 ±0. 11 ） ml; peak acoustic admittance value （Y） ： （0. 60 ±0. 25） mmho; the width of tympanometry （TW） ： （132. 48 ± 31.36） dapa; external auditory canal pressure at peak acoustic admittance value （TPP） ： （20. 47 ± 35. 01 ） dapa. Conclusion： The diagnostic coincidence rate of 1 000 Hz probe tone tympanometry and CT scanning was high. The normal value of 1 000 Hz probe tone tympanometry can be used as a criterion to predict the infants with secretory tympanitis combined with tympanum fluid or not in clinical practices.

关 键 词：鼓室导抗测试 鼓室导抗图 分泌性中耳炎 CT扫描 婴幼儿 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]