外中耳正常汉族婴幼儿宽频声导抗能量反射值的观察

Wide band typanometry energy reflectance in Chinese infants and children with normal outer and middle ears

目的 测量外中耳正常汉族婴幼儿宽频声导抗的能量反射值,为宽频声导抗的临床应用提供参考.方法 选取耳廓、外耳道及鼓膜形态正常,颞骨CT扫描外中耳及内耳结构无异常,且226 Hz及1 000 Hz鼓室图正常的汉族婴幼儿94例（170耳）,年龄3～48个月,中位年龄14个月.根据月龄分为3～6月龄组（32耳）、7～12月龄组（53耳）、13～ 24月龄组（46耳）及25～ 48月龄组（39耳）.对各组受试婴幼儿进行宽频声导抗测试,采用SPSS 15.0统计软件：分析不同频率能量反射的基本规律及年龄因素对能量反射的影响.结果 宽频声导抗的能量反射值在低频处较高,随频率增大逐渐下降,在4 000 Hz附近达最小值,之后又不断上升直到8 000 Hz.3～6月龄婴幼儿1 000 Hz以下及6 350 Hz以上频率范围内的能量反射值明显低于其他各月龄组,差异具有统计学意义（P值均＜0.05）.6月龄以下组能量反射值低、波动范围大,6月龄以上组能量反射值高、波动范围小.结论 汉族外中耳正常婴幼儿的宽频声导抗能量反射值在不同频率的变化趋势与国内外文献报道基本一致.随着年龄的增长,宽频声导抗的能量反射值会发生变化,出生6个月以后逐渐趋于稳定.

Objective To explore the law of wide band typanometry energy reflectance （WBTER） in Chinese infants of Han nationality with normal outer and middle ears,and to provide the normal values for the clinical application of WBTER.Methods Ninety four infants （170 ears） of Han nationality with normal outer and middle ears evidenced by temporal bone CT,and 226 Hz and 1 000 Hz tympanometry at the ages between three and 48 months （median age：14 months） were selected and divided into four groups：3-6 months（32 ears）,7-12 months（53 ears）,13-24 months（46 ears） and 25-48 months（39 ears）.WBTER was conducted on these infants,and the basic law of energy reflectance under different frequencies,as well as the influence of age on energy reflectance were analyzed using SPSS 15.0.Results The normal value of energy reflectance was higher at low frequency,gradually decreased with the increase of frequency,reached the minimum near 4 000Hz,followed by constantly increased till 8 000Hz.In the scope of frequency below 1 000Hz and above 6 350 Hz,the energy reflectance values of infants in the group of 3-6 months were significantly lower than those of infants in other age groups （P ＜ 0.05）.In comparison to the group below six months,the groups over six months generally had higher energy reflectance and lower fluctuation.Conclusions The pattern of energy reflectance across frequency range for Chinese infants and children was consistent with that of other races reported in foreign countries.The WBTER changes with the growing of age,which tends to be stable after the first six months of birth.