咽鼓管-鼓室气流动态图法与音响法检测咽鼓管开放功能比较

Comparison of Tubo-tympano-aerography and Sonotubometry for Detecting Eustachian Tube Opening Function

目的通过比较音响法和咽鼓管-鼓室气流动态图(tubo-tympano-aerography,TTAG)检查咽鼓管开放功能的差异,探讨咽鼓管开放功能的综合评估方法及意义。方法对129例(211耳)主诉耳闷胀不适、耳痛、耳鸣的患者(鼓膜完整且排除咽鼓管异常开放)分别用音响法和TTAG法评估咽鼓管开放功能,依据检测的曲线特点及吞咽次数将TTAG法结果分为正常I型、正常II型及开放不良,音响法结果分为正常及开放不良,比较两种方法检查的结果。结果211耳音响法检测出延迟开放型咽鼓管功能障碍的阳性率为26.07%(55/211),TTAG法检测的阳性率为23.22%(49/211),前者略高于后者,但差异无统计学意义(P=0.498),两种检查的一致率为74.41%,Kapaa=0.312。在咽鼓管开放时TTAG法I型者鼻咽腔压强平均值为482.70±126.74 daPa,TTAG法II型者为418.84±152.70 daPa,两者差异无统计学意义(P=0.168);TTAG法I型者外耳道压强平均值为42.29±18.28 daPa,TTAG法II型者为36.88±16.25 daPa,前者大于后者,差异有统计学意义(P=0.004);TTAG法I型者音响法测得咽鼓管开放持续时间为220.48±94.28 ms,TTAG法II型者为423.99±207.13 ms,前者小于后者,差异有统计学意义(P<0.001)。结论音响法与TTAG法对延迟开放型咽鼓管功能障碍检查的敏感性基本相同;TTAG法I型者气流经咽鼓管进出较TTAG法II型者顺畅,提示TTAG法II型者形成延迟开放型咽鼓管功能障碍的倾向性更明显。

Objective To investigate the differences between the sonotubometry and the tubo-tympano-aerography(TTAG)in testing the eustachian tube opening function of patients,and provide more information for clinical practice.Methods The eustachian tube function test by TTAG and sonotubometry were used in 129 patients(211 ears).TTAG results were divided into normal type I,normal type II and poor opening,sonotubometry results were divided into normal and poor opening.The results were compared.Results The positive rate of sonotubometry was 26.07%(55/211),and the positive rate of the TTAG was 23.22%(49/211).The former was higher than the latter,but the difference was no statistically significant(P=0.498).The consistency rate of the two tests was 74.41%,Kapaa=0.312.The average nasopharyngeal pressure of TTAG type I was 482.70±126.74,and the average value of TTAG type II nasopharyngeal pressure was 418.84±152.70,there was no significant difference between the two types(P=0.168).The average pressure of the external auditory canal pressure of TTAG type I was 42.29±18.28,and the average value of TTAG type II was 36.88±16.25.there was significant difference between the two types(P=0.004).The average duration of eustachian tube opening measured by sonotubometry of TTAG type I was 220.48±94.28,and the average value of TTAG type II was 423.99±207.13,the former was less than that in the latter,and the difference was statistically significant(P<0.001).Conclusion There was no significant difference between TTAG and sonotubometry in detecting delayed open Eustachian tube dysfunction.TTAG type IIpatients may be more suscepitibls to deloyed open enstachian olysfunction.