分泌性中耳炎中耳不同程度积液宽频声导抗分析及有限元模型验证  

Wideband Acoustic Immittance in Otitis Media With Various Levels of Effusion Analysis and Finite Element and Model Validation

作　　者：李行 柳佩涵 蒋雯 刘后广[2] 乔月华 刘稳 LI Hang;LIU Peihan;JIANG Wen;LIU Houguang;QIAO Yuehua;LIU Wen(Dalian Third People's Hospital,Dalian 116000,China;不详)

机构地区：[1]大连市第三人民医院耳鼻咽喉科,大连116000 [2]中国矿业大学机电工程学院 [3]徐州医科大学第一临床医学院 [4]徐州医科大学附属医院耳鼻咽喉科 [5]江苏省人工听觉工程实验室

出　　处：《中华耳科学杂志》2025年第2期220-227,共8页Chinese Journal of Otology

基　　金：国家自然科学基金(52275296)。

摘　　要：目的使用宽频声导抗明确分泌性中耳炎中耳积液程度,探索中耳病理与声能吸收率关系并应用有限元方法进行验证。方法选取2022年1月至2022年7月徐州医科大学附属医院耳鼻咽喉科确诊为分泌性中耳炎(secretory otitis media,SOM)的患儿34例为SOM组,纳入同期就诊的正常儿童40例为对照组。完善纯音测听、226 Hz声导抗、宽频声导抗、电子耳镜检查。SOM组按积液不同程度分为部分积液组与全部积液组,分析组间声能吸收率特点。采用有限元法构建25%、50%、64%、100%积液模型,计算能量吸收率。结果SOM组声能吸收率曲线呈平坦曲线,500~4000 Hz处声能吸收率低于对照组,差异有统计学意义(P<0.05);全部积液组声能吸收率曲线平坦无峰,800~6000 Hz低于部分积液组,差异有统计学意义(P<0.05)。有限元构建的积液模型随积液量增加吸收率逐渐下降。中耳积液量占中耳腔体积25%时,曲线整体走势与正常人耳能量吸收率曲线走势一致;中耳积液量达中耳腔体积50%时,800~8000 Hz处的能量吸收率均值约为20%;中耳积液量占中耳腔体积64%时,整体能量吸收率均值约为10%;中耳积液量占中耳腔体积100%时,能量吸收率为0。结论不同程度的鼓室积液其宽频声导抗声能吸收率不同。有限元模型能够较好地模拟中耳积液状态,其声能吸收率变化能够反映鼓室积液的程度。Objective To determine the degree of middle ear effusion using wideband acoustic immittance and the relationship between middle ear pathology and acoustic absorptivity using a finite element method.Methods A total of 34 children diagnosed with otitis media with effusion(SOM)and 40 healthy children were recruited from January 2022 to July 2022,Department of Otolaryngology,Xuzhou Medical University Affiliated Hospital.Based the degrees of effusion,children with effusion were categorized as partial or full effusion.Characteristics of energy absorption between the two groups were compared.A finite element method was used to construct models of 25%,50%,64%and 100%fluid accumulation,and the rate of energy absorption was calculated.Results Children with SOM showed flat immitance curves lower than those in healthy children at 500-4000 Hz(P<0.05).Sound absorption curves in children with full fluid accumulation were flat with no peaks,and lower than in those with partial fluid accumulation 800-6000 Hz(P<0.05).The finite elements model showed a gradually decreases in rate of energy absorption with increase of fluid accumulation.With effusion at up to 25%of the middle ear cavity,the overall energy absorption curve paralleled that in normal human ears.The rate of energy absorption was about 20%when effusion reached 50%of middle ear volume at 800-8000 Hz,about 10%when fluid reached 64%of middle ear volume,and 0 when fluid reached 100%of middle ear volume.Conclusion The rate of wideband acoustic absorption varies with the level of tympanic effusion.The finite element model can simulate the state of middle ear effusion,showing sound energy absorption rates that can reflect the degree of tympanic effusion.

关 键 词：分泌性中耳炎 有限元分析 声能吸收率 中耳功能 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]