唇腭裂患儿分泌性中耳炎宽频声导抗分析  

Analysis of Wideband Acoustic Immittance of SecretoryOtitis Media in Children with Cleft Lip and Palate

作　　者：陈肇臻 刘华涛 卓明英 杨峰 郑杰 CHEN Zhao-zhen;LIU Hua-tao;ZHUO Ming-ying;YANG Feng;ZHENG Jie(Department of Otolaryngology Head and Neck Surgery,Xiamen Changgeng Hospital,Xiamen 361028,China;Department of Stomatology,Xiamen Changgeng Hospital,Xiamen 361028,China)

机构地区：[1]厦门长庚医院耳鼻咽喉头颈外科,福建厦门361028 [2]厦门长庚医院口腔科,福建厦门361028

出　　处：《实用临床医学（江西）》2023年第2期58-61,80,共5页Practical Clinical Medicine

摘　　要：目的探讨宽频声导抗检查判断婴幼儿期唇腭裂患儿是否存在中耳积液的准确性。方法对56例(112耳)婴幼儿期唇腭裂患儿在行腭裂修补术前同时行传统单频声导抗(按鼓室图分型,A型为正常、B及C型为异常)及宽频声导抗[分为N型吸收曲线(正常)和非N型吸收曲线(异常)]检查。术中由耳鼻喉科医师先行鼓膜切开置管术,后由口腔科医师行腭裂修补术。所有患耳均在鼓膜前下行小放射状切口,如有鼓室积液,延长切口并置入小号鼓膜通气管,记录有无中耳积液。对2种检查的正常及异常结果分别进行比较。结果56例唇腭裂患儿112耳中,中耳积液发生率为58.93%(66/112)。鼓室图A型29耳,其中有中耳积液者10耳,占34.48%;鼓室图B及C型83耳,其中有中耳积液者56耳,占67.46%。宽频声导抗N型曲线20耳,其中有中耳积液者1例,占5.00%;非N型曲线92耳,其中有中耳积液者65例,占70.65%。正常鼓室图(A型)患儿中耳积液发生率高于正常宽频声导抗(N型曲线)患儿(P<0.05);异常鼓室图(B+C型)患儿中耳积液发生率与异常宽频声导抗(非N型曲线)患儿比较差异无统计学意义(P>0.05)。结论传统单频声导抗异常鼓室图与异常宽频声导抗判断婴幼儿唇腭裂患儿存在中耳积液的准确性无明显差异,而正常宽频声导抗判断鼓室内无中耳积液较正常鼓室图更为准确。宽频声导抗可作为传统单频声导抗检查的有效补充。Objective To analyze the accuracy of wideband acoustic immittance in the detection of middle ear effusion in infants with cleft lip and palate.Methods Fifty-six infants with cleft lip and palate(112 ears)underwent traditional single-frequency acoustic immittance(type A:normal tympanogram;type B/C:abnormal tympanogram)and wideband acoustic immittance(normal N-shaped absorption curve;abnormal non-N-shaped absorption curve)before cleft palate repair.During the operation,the otolaryngologist performed myringotomy and tube insertion,and then the stomatologist performed cleft palate repair.In all the affected ears,a small radial incision was made in front of the tympanic membrane.If there was tympanic effusion,the incision was extended and a small tympanic membrane vent tube was inserted.The middle ear effusion was recorded.The normal and abnormal results of the two examinations were compared,respectively.Results Among the 112 ears of the 56 children with cleft lip and palate,the incidence of middle ear effusion was 58.93%(66/112).Middle ear effusion was found in 10(34.48%)of 29 ears with type A tympanogram,in 56(67.46%)of 83 ears with type B or C tympanogram,in 1(5.00%)of 20 ears with N-shaped absorption curve,and in 65(70.65%)of 92 ears with non-N-shaped absorption curve.The incidence of middle ear effusion in children with normal tympanogram was higher than that in those with normal wideband acoustic immittance(P<0.05).There was no significant difference in the incidence of middle ear effusion between those with abnormal tympanogram and those with abnormal wideband acoustic immittance(P>0.05).Conclusion There is no significant difference in the accuracy of middle ear effusion detection between abnormal single-frequency acoustic immittance tympanogram and abnormal wideband acoustic immittance in infants with cleft lip and palate.However,normal wideband acoustic immittance is more accurate than normal tympanogram to determine middle ear effusion.Therefore,wideband acoustic immittance can be used as an effective supple

关 键 词：腭裂 分泌性中耳炎 腭裂修复术 鼓膜置管术 宽频声导抗 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]