耳内镜及纯音测听、声导抗检查对分泌性中耳炎的意义

Significance of ear endoscopy, pure tone audiometry and acoustic impedance test in secretory otitis media

分析耳内镜、纯音测听及声导抗检查对分泌性中耳炎(SOM)的诊断效能。回顾性分析经本院确诊的120例SOM患者(166患耳),耳内镜下鼓膜颜色、活动度、光泽度,计算鼓膜颜色变化、活动度受限、鼓室积液征发生情况;记录纯音测听结果;比较声导抗指标:鼓室压、声顺值、鼓室导纳图曲线梯度(Grad值);计算B型、C型鼓室图出现情况;结果显示,耳内镜下SOM患耳表现为鼓膜呈淡黄色或琥珀色、鼓膜活动受限、见气泡或气液平面;纯音测听时SOM患耳可出现气导听阈减退或气导、骨导听阈均减退,0.5~4 kHz气骨导差≥15 dB;SOM患者声导抗检查可见B型、C型鼓室图。SOM患耳组声导抗检查中鼓室压、声顺值及Grad均显著低于正常耳(P<0.05)。结果提示,耳内镜、纯音测听及声导抗检查是SOM重要的检查手段,在SOM诊断中有较大应用价值。

The aim is to analyze the diagnostic efficacy of ear endoscopy,pure tone audiometry and acoustic impedance test on secretory otitis media(SOM).120 SOM patients(166 ears)diagnosed by the hospital were retrospectively analyzed.The tympanic membrane color,activity and glossiness were observed under ear endoscopy,and the tympanic membrane color change,activity limitation and tympanic effusion sign were calculated,and the pure tone audiometry results were recorded,and the acoustic impedance indicators were compared,including tympanic pressure,acoustic compliance value and tympanic admittance curve gradient(Grad value).The occurrence of B-type diagram,C-type diagram were calculated.Results revealed SOM affected ear under ear endoscopy showed pale yellow or amber tympanic membrane,activity limitation of tympanic membrane,and air bubble or air fluid level.SOM affected ear under pure tone audiometry could show decreased air conduction hearing threshold or reduced air conduction and bone conduction hearing threshold,and 0.5~4 kHz air-bone gap≥15 dB.B-type and C-type tympanograms could be seen in the acoustic impedance test of SOM patients.The tympanic pressure,acoustic compliance value and Grad in acoustic impedance test of SOM patients were significantly lower than those in normal ears(P<0.05).Result suggests that ear endoscopy,pure tone audiometry and acoustic impedance test are important examination methods for SOM,and have great application value in SOM diagnosis.