声导抗测试在婴儿中的应用

Application of Tympanometry in Infants

目的评价不同频率探测音声导抗测试及500、1000Hz镫骨肌反射测试在诊断婴儿中耳功能中的作用。方法使用GSITympstar中耳分析仪,对128例听力正常婴儿(256耳)和104例听力异常婴儿(166耳)进行226、678、1000Hz探测音声导抗测试及500、1000Hz镫骨肌反射测试,并进行比较。结果226Hz探测音鼓室导抗图表现为单峰型、双峰型、无峰型图形,<6月龄婴儿的226Hz探测音鼓室导抗图的图形特点在听力正常组和异常组间的差异无统计学意义;各月龄组的678、1000Hz探测音鼓室导抗图的图形特点在听力正常组和异常组间的差异具有统计学意义(P<0.05)。500Hz镫骨肌反射引出率与1000Hz镫骨肌反射引出率在同年龄组无明显差异(P>0.05),而在听力正常和异常组之间均具有明显差异(P<0.05)。结论678、1000Hz探测音声导抗测试是诊断小于6月龄婴儿中耳功能较准确的检查方法,3种频率探测音声导抗测试对于诊断6月龄～1岁婴儿均较敏感。500和1000Hz镫骨肌反射引出率在同月龄婴儿无明显差异,且随着年龄增长镫骨肌反射引出率逐渐增加。

Objective To study the effects of multi frequency tympanometry and acoustic stapedius reflexes on the diagnosis of the middle ear functions of infants. Methods Tympanometries with 226, 678 and 1 000 Hz probe tones and 500 and 1 000 Hz acoustic stapedius reflexes were performed on infants at age 0- 1 year. 128 normal infants （256 ears） and 104 abnormal infants （168 ears） were tested with GSI Tympstar middle ear analyzer. Results The patterns of 226 Hz tympanograms were non-peaked, single-peaked and W-shaped. There were no significant differences between two groups of infants aged 0-6 months. The patterns of 678 Hz and 1 000 Hz tympanograms showed significant differences between two groups of infants aged 0- 1 year. The outcomes of 500 Hz and 1 000 Hz acoustic stapedius reflexes showed no differences between the same age groups. There were significant differences between normal group and abnormal group. Conclusion Tympanometry with 678 Hz and 1 000 Hz probe tones can yield accurate diagnostic results in the assessment of the middle ear functions for infants younger than six months. The tympanometry with three frequency probe tones is sensitive to infants aged 6-12 months. The outcomes of acoustic stapedius reflexes at 500 and 1 000 Hz show no differences between the same age groups, but presences become more noticeable as a function of ages.