摘要
目的分析儿童分泌性中耳炎的听力学特征，探讨不同听力学测试方法在儿童分泌性中耳炎诊断中的作用和准确性，为儿童分泌性中耳炎的诊断提供理论依据。方法回顾性分析2010年1月-2011年6月诊断为分泌性中耳炎住院治疗的4690（81耳）患儿的资料。所有患儿均行中耳鼓膜切开，将声导抗、畸变产物耳声发射（DPOAE）、听性脑干反应（ABR）、纯音测听（puretoneaudiometry，PTA）结果与术中所见进行比较分析，了解不同听力学测试方法在评估儿童分泌性中耳炎中的作用和准确性。结果①46例（81耳）患儿的DPOAE检查结果均提示双耳未通过，声导抗检查均为B型导抗图。鼓膜切开证实70耳有分泌物（86．42％），11耳无明显分泌物（13．58％）。②34例（59耳）行ABR测试的患儿，鼓膜切开证实49耳（83．05％）有积液，其中6耳ABR反应阈正常，43耳ABR反应阈升高；46耳ABRl波潜伏期延长，3耳l波潜伏期正常。鼓膜切开证实无积液的10耳（16．95％），5耳ABR反应阈正常，5耳ABR反应阈升高；4耳ABRI波潜伏期延长，6耳I波潜伏期正常。③1290（22耳）行PTA测试的患儿，所有耳的听阈值均异常，气骨导差均大于10dB，鼓膜切开证实22耳均有积液。④统计学分析结果显示，ABR气导反应阈值（Kappa=O．364，P〈0．01）、I波潜伏期（Kappa=O．561，P〈O．01）与中耳积液有相关性。结论声导抗测试对评估儿童分泌性中耳炎有较高的敏感性，PTA气导听阈及气骨导差、ABR气导反应阈值、ABRl波潜伏期及DPOAE亦可较好地反映儿童中耳功能。
Objective To analyze the audiological characteristics of children with secretory otitis media （SOM） and to validate different hearing tests in the diagnosis of SOM. Methods The audiological data of 46 SOM patients （81 ears） were retrospectively studied. All the children received the tympanotomy.The acoustic immittance measurement, distortion product otoacoustic emission （DPOAE）, auditory brainstem response （ABR） and pure-tone audometry （PTA）results were compared with the findings during the operation. Results All the 81 ears failed to pass DPOAE tests and the acoustic immittance measurement showed a B-type tympanogram. The tympanotomy found 70 ears （86.42%） with effusion and 11 ears without effusion （13.58%）. Thirty-four children （59 ears） received the ABR test. The tympanotomy found that there were49 ears （83.05%） with effusion, including 6 ears with normal ABR thresholds and 43 ears with increased ABR thresholds. The latencies of ABR wave I were prolonged in 46 ears and normal in 3 ears. The tympanotomy also found 10 ears without effusion, including 5 ears with normal ABR thresholds and 5 ears with increased ABR thresholds. The latencies of ABR wave I were prolonged in 4 ears and normal in 6 ears. The hearing thresholds of all the 12 patients （22 ears） who received the pure-tone audiometry were abnormal with over 10 dB air-bone gaps. The tympanotomy showed that all these 22 ears had effusion. The statistical analysis indicated that the air-conduction ABR thresholds （Kappa=O.364,P〈O.01） and the latencies of ABR wave I（Kappa=O.561,P〈O.01） were related to the effusion in the middle ears. Conclusion The acoustic immittance measurement is highly sensitive in evaluating the children with SOM. The air- conduction ABR thresholds, ABR wave I latencies, PTA thresholds, air-bone gap and DPOAEcould also reflect the function of middle ears effectively.
出处
《中国听力语言康复科学杂志》
2012年第3期189-192,共4页
Chinese Scientific Journal of Hearing and Speech Rehabilitation
基金
广州市妇女儿童医疗中心博士启动基金（5201-2090056）
关键词
分泌性中耳炎
儿童
声导抗测试
听性脑干反应
畸变产物耳声发射
纯音测听
Secretory otitis media
Child
Acoustic immittance measurement
Auditorybrainstem response
Distortion product otoacoustic emission
Pure-tone audiometry
