腺样体组织大小与位置对分泌性中耳炎患儿听力阈值的影响  

Impact of adenoid size and location on auditory threshold in children with otitis media with effusion

作　　者：李熙星 赵宇亮 崔卫娜[1] LI Xixing;ZHAO Yuliang;CUI Weina(Department of Otolaryngology Head and Neck Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院耳鼻咽喉头颈外科,河北石家庄050000

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第6期36-39,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：2021年度省卫健委青年科技课题(20211178)。

摘　　要：目的探讨腺样体组织的大小及位置对分泌性中耳炎(OME)患儿听力阈值的影响。方法收集4岁以上临床诊断为OME的患儿94例(152耳),使用电子鼻咽镜检查腺样体的大小和位置。根据腺样体对后鼻孔的阻塞程度由小到大,将患儿分为4组,其中组一25例(43耳),组二31例(47耳),组三27例(44耳),组四11例(18耳);根据腺样体组织与咽鼓管咽口的毗邻位置关系,将患儿分为3组,其中A组41例(62耳),B组34例(54耳),C组19例(36耳)。采用纯音测听来测定骨导和气导阈值,以0.5、1、2、4 kHz 4个频率计算平均听力阈值。通过统计学分析探究腺样体组织的大小和位置分别对OME患儿听力阈值的影响。结果腺样体组织的大小和位置与OME患儿的听力阈值之间无相关性(P>0.05);鼓室导抗图呈B型的患儿平均听力阈值明显高于鼓室导抗图呈C型的患儿(P<0.001)。在腺样体大小及位置分组中各组间患儿B型和C型鼓室导抗图分布无统计学差异(P>0.05)。结论腺样体的大小和位置对OME患儿的听力阈值无影响。对于4岁以上的OME患儿,在进行腺样体切除术前应谨慎,除非存在明确的腺样体切除术指征,如鼻塞、打鼾或慢性腺样体炎等,否则不应单纯基于腺样体的大小及对咽鼓管的阻塞程度或仅因短期内存在OME来决定进行腺样体切除术。Objective To investigate the effect of size and location of adenoid tissue on the hearing threshold in children with otitis media with effusion(OME).Methods A total of 94 children(152 ears)over 4 years old with clinical diagnosis of OME were included in this study.The size and location of their adenoids were examined using electronic nasopharyngoscopy.According to the degree of adenoids causing choanal obstruction from small to large,the children were divided into 4 groups.group 1(n=25,43 ears),group 2(n=31,47 ears),group 3(n=27,44 ears),and group 4(n=11,18 ears).According to the relationship between the adenoid tissue and the torus tubarius of the eustachian tube,the children were divided into 3 groups,including 41 cases(62 ears)in group A,34 cases(54 ears)in group B and 19 cases(36 ears)in group C.Bone and air conduction thresholds were determined by pure tone audiometry,and their average values were calculated at four frequencies of 0.5,1,2 and 4 kHz.The effect of the size and location of adenoid tissue on the hearing threshold in children with OME was investigated statistically.Results There was no correlation between the size and location of adenoid tissue and the hearing threshold in children with OME(P>0.05).The average hearing threshold of children with tympanogram type B was significantly higher than that of tympanogram type C(P<0.001).There was no significant difference in the proportion of tympanogram type B or C among the groups according to adenoid size or location(P>0.05).Conclusions The hearing threshold in children with OME is not affected by the size and location of adenoid tissue.Caution should be exercised before adenoidectomy in children over 4 years of age with OME,unless there is a clear indication of adenoidectomy,such as nasal congestion,snoring,or chronic adenoiditis.Otherwise,adenoidectomy should not be based solely on the size of the adenoid and the degree of obstruction to the eustachian tube or the presence of OME in the short term.

关 键 词：分泌性中耳炎 腺样体 儿童 纯音测听 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]