分泌性中耳炎误诊漏诊原因分析

Causes of mistaken diagnosis of secretory otitis media

目的减少分泌性中耳炎的误诊和漏诊。方法对1999年1月—2003年10月资料完整的382耳分泌性中耳炎中曾发生误诊、漏诊的38耳进行回顾分析。结果误诊原因有四方面:1症状不典型;2病史询问不详细;3检查鼓膜不仔细;4综合分析不全面。结论应根据年龄、病史,结合听力图进行综合分析;声导抗测试对分泌性中耳炎的诊断符合率达99%,怀疑本病时应进行常规检查。

Objective To reduce mistaken diagnosis of secretory otitis media (SOM). Methods During the years of 1999-2003, 362cases (382ears) with intact data were diagnosed as SOM and analyzed retrospectively, in which 33 cases (38 ears) failed to be correctly diagnosed. Results There were four causes for misdiagnosis of SOM: (1)equivocal symptoms;(2) carelessness in history-taking;(3) carelessness in examining the tympanic membrane;(4)the lack of a comprehensive study for the symptoms and physical signs. Conclusions A comprehensive analysis should be made on the basis of the age, the past history and pure tone audiogram of the patients. Acoustic immitance mesurements have a 99% positive rate in diagnosis of SOM and should be used as a routine measurement for all SOM suspects.