2~6岁分泌性中耳炎儿童226 Hz和1000 Hz鼓室导抗图特征

Characteristics of 226 Hz Tympanometry and 1000 Hz Tympanometry in Children Diagnosed with Otitis Media with Effusion Aged 2 to 6 Years Old

目的分析2~6岁分泌性中耳炎儿童226 Hz和1000 Hz鼓室导抗图的特征,探讨不同频率探测音鼓室导抗图对儿童分泌性中耳炎的诊断价值。方法研究对象为2019年3月至2020年12月经鼓膜切开术抽出积液确诊的2~6岁分泌性中耳炎患儿(33例,其中男20例、女13例,共52耳),分析其术前226 Hz和1000 Hz声导抗测试的结果,比较两种探测音鼓室导抗图诊断分泌性中耳炎的敏感性。结果2~6岁分泌性中耳炎患儿226 Hz鼓室导抗图A型1.92%、As型15.38%、B型21.15%、C型61.55%,无Ad型;鼓室导抗图宽度(tympanometric width,TW)值≤200 daPa占15.38%、TW值>200 daPa占61.54%、TW值测不出占23.08%。1000 Hz鼓室导抗图分型中正峰1.92%、无峰84.62%、正峰负压13.46%。226 Hz鼓室导抗图TW值和1000 Hz鼓室导抗图分型诊断分泌性中耳炎的敏感性分别为84.62%和84.62%,高于226 Hz鼓室导抗图分型(21.15%),差异有统计学意义(P<0.01)。结论1000 Hz声导抗测试对2~6岁儿童分泌性中耳炎的诊断敏感性较226 Hz声导抗测试更高,建议联合测试并交叉验证结果以减少漏诊。

Objective To provide a clinical reference in diagnosing otitis media with effusion in children aged 2 to 6 years old via analyzing characteristics of 226 Hz tympanometry and 1000 Hz tympanometry.Methods This study included 33 children(52 ears)aged 2 to 6 years who were diagnosed with otitis media with effusion by myringotomy from March 2019 to December 2020.They all received 226 Hz and 1000 Hz tympanometry.The results of 226 Hz tympanogram and 1000 Hz tympanogram were analyzed and the sensitivity of each parameter in diagnosing otitis media with effusion was compared.Results In children diagnosed as otitis media with effusion,the types of 226 Hz tympanogram were as follow type A accounted for 1.92%,type As accounted for 15.38%,type Ad accounted for 0.00%,type B accounted for 21.15%,type C accounted for 61.55%.The distribution of width values of 226 Hz tympanogram were 15.38%for≤200 daPa,61.54%for>200 daPa and 23.08%with no value.The types of 1000 Hz tympanogram were 1.92%with positive peak,84.62%with no peak and 13.46%with positive peak and negative pressure.The sensitivities of tympanometric width value and types of 1000 Hz tympanogram were 84.62%and 84.62%respectively,which were higher than those of 226 Hz tympanogram(21.15%).Conclusion The sensitivity of 1000 Hz tympanogram was higher than that of 226 Hz tympanogram in diagnosing otitis media with effusion in children aged 2 to 6 years old.226 Hz tympanometry and 1000 Hz tympanometry should be done at the same time for proper diagnosis.