宽频声导抗应用于内耳疾病诊断研究的系统评价  

The Value ofWideband Acoustic Immittance in Identification of Inner Ear Pathology:A Systematic Review

作　　者：岳昱宏 木怡 刘洁 林欢 乔月华 刘稳 蒋雯 YUE Yuhong;MU Yi;LIU Jie;LIN Huan;QIAO Yuehua;LIU Wen;JIANG Wen(Second Clinical Medical College of Xuzhou Medical University,Xuzhou 22100,China;不详)

机构地区：[1]徐州医科大学第二临床医学院,徐州221000 [2]江苏省人工听觉工程实验室 [3]徐州医科大学附属医院耳鼻咽喉科

出　　处：《中华耳科学杂志》2024年第1期125-129,共5页Chinese Journal of Otology

基　　金：江苏省研究生科研与实践创新计划项目(KYCX23_2940)。

摘　　要：目的系统评价宽频声导抗在内耳疾病诊断中的应用价值,分析和综合现有文献证据,探讨其在不同内耳疾病中的诊断效能。方法在PubMed、Web of Science和中国知网期刊数据库中检索建库至2023年的中英文文献,筛选出符合纳排标准的宽频声导抗应用于内耳疾病的研究。采用QUADAS-2工具评估纳入研究的方法学质量,并提取每个研究的基本信息进行定性描述。在评估文献质量之前,咨询听力学专家修改了QUADAS-2工具的条目,并由2名评审员独立评价,第3名评审员进行方法学质量审查。提取的资料包括:作者、发表时间、纳入耳数、年龄、种族、影像学检查及分析参数。结果共纳入17项原始研究,其中7项关于梅尼埃病诊断,4项关于大前庭导水管综合征,5项关于上半规管裂,1项关于内淋巴积水。这些研究主要发表于2019—2023年,反映了该领域的新进展。但是,现有研究样本量普遍较小,分析指标不统一,对同一疾病的结论存在差异。QUADAS-2工具评价结果显示,多数研究在病例选择和待评价诊断试验方面存在偏倚风险,影响了研究质量。结论宽频声导抗作为一种快速无创的听力检测方法受到越来越多的关注,但在内耳疾病诊断方面仍需深入探索。目前的研究进展存在以下不足,样本量不足,结果可信度低;试验方法学设计不严谨,偏倚风险高;同一疾病的结论不一致,需进一步验证。因此,宽频声导抗在内耳疾病诊断中虽有一定指导意义,但亟需提高研究质量,挖掘其可靠的诊断效能。Objective The goal of this review is to assess the diagnostic utility of wideband acoustic immittance(WAI)in identifying inner ear diseases through comprehensive analysis and synthesis of existing literatures.Methods A systematic literature search was conducted across databases including PubMed,Web of Science,and CNKI,for articles in both English and Chinese pertaining to application of WAI in identification of inner ear diseases published up to July 2023.Studies were selected based on predetermined criteria and their quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2)tool.Prior to assessing the quality of the articles,audiology experts were consulted to refine the QUADAS-2 parameters.Two independent reviewers,along with a third one for methodological quality,were involved in the evaluation process.Key data extracted from each study included authorship,publication date,sample size,demographic details,and analysis parameters.Results The review included 17 original studies,7 on Meniere's disease,4 on large vestibular aqueduct syndrome,5 on superior semicircular canal dehiscence,and 1 on endolymphatic hydrops.Most studies were published between 2019 and 2023,reflecting on-going progresses in this field.Relatively small sample sizes,non-uniform analysis metrics,and divergent conclusions for similar diseases were some of the issues noticed in the selected studies.QUADAS-2 evaluation revealed potential biases due to inadequate details on case selection,blinding during evaluation,and interpretation of diagnostic test results.Conclusion While WAI,as a rapid,non-invasive audiological assessment tool,has garnered increasing interests,it requires further investigation in the context of inner ear disease diagnosis.Primary limitations of current research include insufficient sample size,low methodological quality and lack of consensus.This review suggests the necessity for robust study design to confirm WAI's diagnostic potentials in inner ear diseases.

关 键 词：宽频声导抗 内耳疾病 QUADAS-2 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]