咽鼓管测压对分泌性中耳炎咽鼓管功能的测试评估  

Tubomanometry in Assessment of Patients with Otitis Media with Effusion

作　　者：仝玉桃 Kelann Belfon 张文静[1] 秦兆冰[1] TONG Yutao;Kelann Belfon;ZHANG Wenjing;QIN Zhaobing(Department of Otolaryngology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450002)

机构地区：[1]郑州大学第一附属医院耳鼻喉科,郑州450002

出　　处：《中华耳科学杂志》2020年第2期310-313,共4页Chinese Journal of Otology

摘　　要：目的研究咽鼓管测压仪(TMM)对分泌性中耳炎(OME)患者咽鼓管功能的测试评估。方法对36例(64耳)OME患者及35例(70耳)正常对照组进行TMM测试,结果以三种压力下(30mbar、40mbar、50mbar)R值显示(R≤1表示咽鼓管正常开放;R>1或未检测到R表示咽鼓管开放延迟或阻塞);同时进行主观Valsalva,声导抗,咽鼓管评分(ETS)和咽鼓管功能障碍问卷-7(ETDQ-7)评估。结果受试者在TMM30、40和50mbar压力下均观察到咽鼓管开放受限,对照组分别为10%,2.86%和1.43%,OME组分别为78.12%,71.83%,和68.75%,两组比较差异显著(30mbar:χ2=63.479 P=0.000;40mbar:χ2=69.273 P=0.000;50mbar:χ2=67.934 P=0.000);咽鼓管开放受限在组内三个压力之间比较,对照组存在显著差异(χ2=9.055 P=0.011)而OME组无统计学意义(χ2=1.477 P=0.478)。OME患者Valsalva结果与TMM 30mbar测试结果一致性较好(χ2=16.663 P=0.000),与40和50mbar结果一致性较差(χ2=3.322 P=0.068和χ2=2.167 P=0.141)。ETS评分与ETDQ-7评分的相关性分析显示两者呈负相关(r=-0.493,P=0.000)。结论TMM结果显示OME患者咽鼓管功能开放障碍,其30mbar时测试结果与Valsalva结果有较好的一致性,ETS与ETDQ-7评分结果呈负相关。Objective To report eustachian tube function evaluation results in patients with otitis media with effusion(OME)by tubomanometry(TMM).Methods Thirty six patients(64 ears)with OME and 35 normal controls(70 ears)were tested by TMM,with R≤1 representing normal eustachian tube opening and R>1 or no R representing eustachian tube opening delay or failure.In addition,data of Valsalva maneuver,impedance audiometry,eustachian tube score(ETS)and eustachian tube dysfunction questionnaire-7(ETDQ-7)were also collected.Results For pressures at 30,40 and 50 mbar,impeded eustachian tube opening was seen in 10%,2.86%and 1.43%of the controls,and 78.12%,71.83%and 68.75%of the OME patients(χ2=63.479,P=0.000;χ2=69.273,P=0.000;andχ2=67.934,P=0.000),respectively.When compared among the pressures,the rate of impeded eustachian tube opening showed differences for different pressures in the control group(χ2=9.055,P=0.011),but not in the OME group(χ2=1.477,P=0.478).In patients with OME,Valsalva results were consistent with TMM results at 30 mbar(χ2=16.663,P=0.000),but not with TMM results at 40 or 50 mbar(χ2=3.322,P=0.068 andχ2=2.167,P=0.141).ETS scores were negatively correlated to ETDQ-7 scores(r=-0.493,P=0.000).Conclusion TMM can identify eustachian tube dysfunction in patients with OME,with results at 30 mbar showing good agreement with Valsalva results.In patients with OME,ETS scores are negatively correlated with ETDQ-7 scores.

关 键 词：分泌性中耳炎 咽鼓管功能 咽鼓管测压仪 评估方法比较 

分 类 号：R764[医药卫生—耳鼻咽喉科]