宽频声导抗与分泌性中耳炎中耳积液黏稠度及气骨导差的相关性研究  

Correlation between Wideband Tympanometry and Viscosity of Middle Ear Effusion and Air-bone Gap in Otitis Media with Effusion

作　　者：周广杰 童步升[1] ZHOU Guangjie;TONG Busheng(First Affiliated Hospital of Anhui Medical University)

机构地区：[1]安徽医科大学第一附属医院,合肥230000

出　　处：《中华耳科学杂志》2020年第3期449-453,共5页Chinese Journal of Otology

摘　　要：目的探讨宽频声导抗吸收率、共振频率与分泌性中耳炎(Otitis media with effusion,OME)中耳积液黏稠度、气骨导差的相关性及其临床意义。方法选取2018年1月——2019年3月期间就诊于我院的,经临床体检、电子耳镜、声导抗、纯音测听等检查以及最终术中证实明确诊断的28例(46耳)的OME患者。对OME患者术前进行纯音测听、传统声导抗检查、WBT测试,获得频率-吸收率(EA值)曲线图以及中耳共振频率值;统计并计算0.5~2kHz平均EA值及共振频率值;术中耳内镜下观察外耳道及鼓膜情况,并探查鼓室,观察中耳积液的性质。比较分析吸收率、共振频率与中耳积液黏稠度以及气骨导差的相关关系。结果吸收率与中耳积液黏稠度以及气骨导差之间的相关系数r及P值分别为r1=-0.943,P1<0.001;r2=-0.960,P2<0.001;吸收率与中耳积液黏稠度以及气骨导差具有负相关关系。共振频率与中耳积液黏稠度以及气骨导差之间的相关系数r及P值分别r3=-0.942,P3<0.001;r4=-0.941,P4<0.001;共振频率与中耳积液黏稠度以及气骨导差也具有负相关关系。结论吸收率、共振频率与中耳积液黏稠度以及气骨导差之间关系密切,呈负相关,吸收率越小,积液越黏稠,气骨导差越大;同样,共振频率越小,积液越黏稠,气骨导差越大。宽频声导抗吸收率、共振频率能够客观地对积液型OME患者病情做出初步的判断,能够简单、快捷、客观地评价患者病情的严重程度,对治疗方案具有指导意义,具有重要的临床应用价值。Objective To investigate the correlation between wideband tympanometry(WBT)absorbance and resonance frequency and the viscosity of middle ear effusion and air-bone gap in otitis media with effusion(OME),and its clinical significance.Methods The study included patients with OME(n=28,46 ears)admitted to our hospital from 2018-01 to 2019-03 who were evaluated and diagnosed by clinical examination,otoscopy,traditional tympanometry,pure tone audiometry and finally surgical findings.Pure tone audiometry,traditional tympanometry test and WBT test were performed before surgery,and the frequency-absorption rate(EA value)curve and middle ear resonance frequency over the 0.5-2 kHz range were obtained.The external auditory canal and tympanic membrane were examined endoscopically during surgery,and the tympanic cavity explored especially the nature of middle ear effusion.The correlation between WBT absorbance,resonance frequency,middle ear effusion viscosity and air-bone gap was analyzed.Results The correlation coefficient r was-0.943(P<0.001)between WBT absorption rate and middle ear effusion viscosity and-0.960(P<0.001)between WBT absorption rate and air-bone gap.The correlation coefficient r was-0.942(P<0.001)between resonance frequency and middle ear effusion viscosity and-0.941(P<0.001)between resonance frequency and air-bone gap.Conclusion Both WBT absorbance and resonance frequency are negatively correlated to the viscosity of middle ear effusion and air-bone gap,and can be used to assess the middle ear condition in patients with effusion-type otitis media and its severity in an easy,quick and objective manner to provide guidance for developing treatment plans.They show important clinical application values.

关 键 词：宽频声导抗 吸收率 共振频率 分泌性中耳炎 黏稠度 气骨导差 

分 类 号：R764[医药卫生—耳鼻咽喉科]