儿童分泌性中耳炎鼓膜置管后中耳功能的综合评价

Comprehensive evaluation of the middle ear function in children with secretory otitis media after tympanotomy tube insertion

目的:探讨儿童分泌性中耳炎(SOM)鼓膜置管后中耳功能综合评价的方法和临床意义。方法:选择31例(43耳)临床诊断为SOM的患儿,分别在鼓膜置管术前及术后1个月,进行纯音听阈测试、畸变产物耳声发射(DPOAE)、鼓室导抗图(记录外耳道容积,ECV)测试;术后1个月加咽鼓管功能正负压平衡测试,并在显微镜下观察置管情况。结果:置管后1个月,39耳置管通畅者ECV>2.0ml,听力比置管前明显提高;DPOAE引出率及部分频率幅值提高,与置管前比较,差异有统计学意义(P<0.01或P<0.05);咽鼓管功能尚无完全正常。结论:应用ECV、纯音听阈测试、DPOAE以及咽鼓管功能测试对患儿鼓膜置管术后中耳功能的恢复情况进行综合评价,具有临床指导意义。

Objective:To study the method on comprehensive evaluation of the middle ear function in children with secretory otitis media(SOM) after tympanotomy tube insertion.Method:Ear cannal volume (ECV), pure tone audiometry and distortion product otoacoustic emission(DPOAE) were carried out in 31 chidren(43 ears) with SOM before and 1 month after tube insertion,in the meantime Eustachian tube function was recorded.The tympanotomy tube was observed under microscope.Result:After one month of tube insertion,the hearing level was improved in 39 ears with an ECV>2.0 ml.In addition,the detection rate and amplitude of DPOAE were significantly increased in these 39 ears.No case of the function of Eustachian tube was complete recoveried.Conclusion:ECV, pure tone audiometry,DPOAE and inflation-deflation test are significantly clinical worth for comprehensive evaluation of the middle ear function in children with SOM after tympanotomy tube insertion.