声导抗测试结合鼓膜摄像在外伤性鼓膜穿孔诊断中的应用

Application of acoustic immittance test combined with tympanic membrane imaging in the diagnosis of traumatic tympanic membrane perforation

目的探讨声导抗检测结合鼓膜摄像在外伤性鼓膜穿孔诊断中的应用价值。方法回顾性分析南京市第二医院门诊2019年4月—2020年4月接诊的37例(共44耳)外伤性鼓膜穿孔患者的临床资料。接诊时详细询问患者病史,采用声导抗检测和/或鼓膜摄像检查。按照检测方法分鼓膜摄像组与联合组(声导抗检测联合鼓膜摄像),对比两种检查方法在外伤性鼓膜穿孔诊断中的灵敏度、特异度及准确度。结果鼓膜摄像组在检测外伤性鼓膜穿孔诊断中的灵敏度为91.12%、特异度为50.00%、准确度为81.82%;联合组在检测外伤性鼓膜穿孔诊断中的灵敏度为100%、特异度为100%、准确度为100%,两组检测方法相比,联合组均高于鼓膜摄像组,差异均具有统计学意义(P<0.05)。结论单纯凭借鼓膜摄像容易发生漏诊误诊,声导抗检测结合鼓膜摄像用于诊断外伤性鼓膜穿孔,其灵敏度、特异度及准确度更高。

Objective To explore the application of acoustic immittance test combined with tympanic membrane imaging in the diagnosis of traumatic tympanic membrane perforation.Methods It was retrospectively analyzed for clinical data of 37 patients(44 ears in total)with traumatic tympanic membrane perforation received in the outpatient department of Nanjing Second Hospital from April 2019 to April 2020.The patient’s medical history was detailed at the time of admission.All patients were examined by immittance instrument and tympanic membrane imaging.According to the detection method,the patients were divided into the tympanic membrane imaging group and the combined group(acoustic immittance test combined with tympanic membrane imaging).They were compared for the sensitivity,specificity and accuracy of the two groups in the diagnosis of traumatic tympanic membrane perforation.Results The sensitivity,specificity and accuracy of the tympanic membrane imaging group were 91.12%,50.00%and 81.82%,while the sensitivity,specificity and accuracy of the combined group were 100%,100%and 100%,respectively.Compared with the two groups,the detection methods in the combined group were higher than those in the tympanic membrane imaging group.There was statistical significance for the difference of two groups(P<0.05).Conclusions The tympanic membrane imaging alone is prone to misdiagnosis.The acoustic immittance test combined with tympanic membrane imaging has higher sensitivity,specificity and accuracy in the diagnosis of traumatic tympanic membrane perforation.