卡哈切迹在儿童分泌性中耳炎诊断中的意义

Predictive role of Carhart notch in assessing the viscosity of middle ear effusion

目的探讨纯音听阈图中卡哈切迹(CN)在儿童分泌性中耳炎(OME)诊断中的意义。方法回顾分析81例(153耳)OME住院患儿的临床资料。收集术前纯音测听图结果,根据CN存在与否、平均气导听阈以25 dB为界、骨气导差以30 dB为界分组,分析CN、平均气导听阈及骨气导差在推测中耳积液性质中的意义。结果 CN存在率为32.7%(50耳),其中47耳证实为黏液,与无CN耳相比积液明显黏稠,差异有统计学意义(P=0.006)。平均气导听阈>25 dB较≤25 dB组积液黏度高,差异有统计学意义(P=0.001)。骨气导差>30 dB组积液黏稠,差异有统计学意义(P=0.008)。结论 CN存在耳积液黏稠。OME患儿术前行纯音测听,同时结合CN存在与否,可以帮助推断积液性质,进行早期手术干预。

Objective To explore the predictive role of the audiometric Carhart notch （CN） in assessing the viscosity of middle ear fluid in children with otitis media with effusion （OME） prior to surgical intervention. Methods Information concerning presence of CN, characteristics of middle ear fluid, preoperative pure-tone average hearing level and air-bone gap results were obtained and the relationship between these factors were analyzed. Results The incidence of CN was 32.7% （50 ears）. The viscosity of middle ear effusion in CN positive ears was higher（P =0.006）. The viscosity of middle ear effusion in ears with average hearing level 〉25 dB tended to be thicker than those ≤25 dB, and the difference was significant （P = 0.001 ）. The association between the size of the air-bone gap and the viscosity of middle ear fluid was also significant with P = 0.008. Conclusions The nature of the effusion in the CN positive ears was thick. Preoperative tympanometric and audiometric variables, CN in particular, may contribute to estimating the viscosity of middle ear fluid so as to be a reference in terms of surgical intervention.