听力正常儿童宽频鼓室图声能吸收率

Wideband Tympanometry Energy Absorbance in Normal-hearing Children

目的探讨听力正常儿童宽频鼓室图(wideband tympanometry,WBT)声能吸收率(energy absorbance,EA)的主要特征及相关影响因素。方法对3~11岁听力正常儿童85例(140耳)(左69耳,右71耳;男78耳,女62耳;3~5岁66耳,6~11岁74耳)进行宽频鼓室图声能吸收率压力测试,获得宽频峰压(wideband tympanometric peak pressure,WBTPP)和0 daPa下107个频率的EA,绘制10%、90%宽频声能吸收率参考范围曲线;选取226 Hz和1/3倍频程共17个频率的EA用于统计分析外耳道压力和年龄对宽频声能吸收率的影响。结果①0 daPa下226~1260 Hz范围内9个频率的EA值显著低于WBTPP下的EA(P值<0.05)。②0 daPa和WBTPP下,3~5岁组4000~5040 Hz内的EA显著高于6~11岁组,在低中频段和8000 Hz则是3~5岁组EA显著低于6~11岁组(P<0.05)。③WBTPP下,3~5岁组和6~11岁组宽频声能吸收率参考范围曲线走势相似,呈左低右高的双峰形态,而0 daPa压力下两年龄组宽频声能吸收率参考范围曲线则为峰值位于高频的单峰形态。结论年龄和外耳道压力会对3~11岁听力正常儿童宽频声能吸收率产生影响,本研究建立了0 daPa和WBTPP两种压力下3~5岁和6~11岁听力正常儿童全频段宽频声能吸收率参考范围曲线,可为临床诊断提供参考。

Objective The study was to investigate the main characteristics and related factors of wideband tympanometry(WBT)enerygy absorbance(EA)in children with normal hearing for clinical practice.Methods According to the inclusion criteria,85 children between 3~11 years old(140 ears)were collected with 69 left ears,71 right ears,78 ears for males,62 ears for females,66 ears for 3~5 years old group and 74 ears for 6~11 years old group.All subjects were tested to obtain between 226 to 8000 Hz at wideband tympanometric peak pressure(WBTPP)and at 0 daPa respectively for establishing wideband EA normative curves(10%~90%wideband EA curves).A total of 17 frequencies(226 Hz and 1/3 octave)were selected to statistically analyze the effects of external auditory canal wideband EA.Results①EA mean values at 9 selected frequencies at 0 daPa between 226 to 1260 Hz were significantly lower than those at WBTPP(P<0.05).②Regardless of different external auditory canal pressures,EA in 3~5 years old group was significantly higher than that in 6~11 years old group at 4000~5040 Hz.For low to middle frequencies and 8000 Hz,3~5 years old group had significantly lower EA than 6~11 years old group(P<0.05).③At WBTPP,the shapes of wideband EA normative curves of two age groups were similar,both showing double peaks,while wideband EA normative curves for the two age groups at 0 daPa were both characterized with a single peak during high frequencies.Regardless of the pressures,the differences in the curves between the two age groups were mainly the peak absorbance and its corresponding frequencies.Conclusion There are effects of ages and external auditory canal pressures on wideband EA in normal-hearing children.The establishment of wideband EA normative curves for 3~5 years old and 6~11 years old normal-hearing children at 0 daPa and WBTPP would be useful for clinical practice for diagnostic purposes.