宽频声导抗应用于评估0-24月龄婴幼儿中耳功能检查的临床研究

Application of Wideband Tympanometry to Middle Ear Function Evaluation in Infants Aged 0-24 Months

目的建立正常0-2周岁中国婴幼儿宽频声导抗(wideband tympanometry,WBT)吸收率的参考值范围。对比正常耳和分泌性中耳炎患儿宽频声导抗的鼓室图结果以及宽频能量吸收率(wideband absorbance,WBA)的差异,探讨宽频声导抗对婴幼儿中耳功能诊断的意义。方法入选者中耳功能正常155例(269耳),诊断为分泌性中耳炎者50例(80耳),绘制正常耳、分泌性中耳炎耳WBT曲线,并对绘制出的曲线吸收率进行比较。结果0~6月龄、7-12月龄和13-24月龄婴幼儿WBT各频率吸收率所分析的31个频率吸收率差异均有统计学意义,三组婴幼儿WBA曲线图形似一个左侧峰高右侧峰低的不对称M形状。分泌性中耳炎组WBA曲线下降最显著的频率范围集中在891~2245Hz。中耳正常0-6月龄组平均鼓室图(averaged tympanogram,AT)的吸收率要均高于7-12月龄组和13-24月龄组,分泌性中耳炎组AT的图形为平坦型。结论本研究建立了0-24月龄中国人群正常耳WBT吸收率以及AT90%参考值,吸收率(WBA)和AT测试可用于临床诊断婴幼儿分泌性中耳炎。

Objective To establish reference absorbance values of wideband tympanometry(WBT)in young Chinese children aged 0-2 years and to test its value in diagnosing middle ear function in infants by comparing wideband absorbance(WBA)between normal ears and ears with secretory otitis media.Methods The study involved 155 children(269 ears)with normal middle ear function and 50 children(80 ears)with secretory otitis media.Using WBT curves,absorbance rates were compared between normal and abnormal ears.Results WBT absorbance rates at 31 frequencies showed statistically significant differences among infants aged 0-6 months,7-12 months and 13-24 months,with similar asymmetrical M shaped WBA curves(higher peak on left).The most significant WBA curve decline was seen in the 891-2245 Hz range.In children with normal middle ear function average tympanum figure(absorption rates on averaged tympanogram(AT))were higher in those 0 to 6 months old than in those 7 to 12 months or 13 to 24 months of age.AT curves were flat in children with secretory otitis media.Conclusion Normal reference WBT absorption rate value and 90% average tympanogram were established for Chinese children aged 0-24 months.WBA and average tympanogram tests can be used for clinical diagnosis of secretory otitis media in infants.