摘要
目的探讨颞骨高分辨率CT（high resolution computerized tomography,HRCT）联合纯音听力测试对鼓室硬化的诊断意义。方法对贵州医科大学附属医院2014年1月~2015年12月期间收治的慢性化脓性中耳炎干耳3个月以上,HRCT提示中耳病变患者176例（181耳）,术前分别采用单纯颞骨HRCT及颞骨HRCT联合纯音测听对鼓室硬化进行诊断,并以术中探查结果为金标准,观察二种方法诊断鼓室硬化的敏感性、特异性、阳性似然比和准确度的差异。结果①单纯颞骨HRCT诊断鼓室硬化敏感性58.55%、特异性93.10%、阳性似然比8.49、阴性似然比0.46和准确度64.09%;②颞骨HRCT联合纯音听力测试诊断鼓室硬化的敏感性为94.08%、特异性89.66%、阳性似然比9.09、阴性似然比0.01和准确度93.37%;分型诊断Ⅰ型符合率89.66%,Ⅱ型87.50%,Ⅲ型84.62%,Ⅳ型82.14%,总的分型诊断符合率为86.18%,诊断效能较单纯颞骨HRCT显著提高。结论颞骨HRCT联合纯音听力测试诊断鼓室硬化有一定价值,为可疑鼓室硬化术前制定手术方案提供依据。
OBJECTIVE To investigate the significance of diagnosis of tempanosclerosis by HRCT combined with pure tone audiometry.METHODS 176patients（181 ears）with chronic suppurative otitis media in stationary phase were recruited in Guizhou Medical University Affiliated Hospital between January 2014 to December 2015.Temporal bone HRCT combined with pure tone audiometry were applied to all patients before operation to diagnose tempanosclerosis.Intraoperative exploration results was the gold standard to observe sensitivity,specificity,positive likelihood ratio and the difference of accuracy of two diagnostic methods.RESULTS 1.The sensitivity,specificity,positive likelihood,negative likelihood ratio and accuracy of tympanosclerosis diagnosed only by temporal bone HRCT were 58.55%,93.10%,8.49,0.46 and64.09%respectively.2.The sensitivity,specificity,positive likelihood,negative likelihood ratio and accuracy of tympanosclerosis diagnosed by HRCT combined with pure tone audiometry were caculated as 94.08%,89.66%,9.09,0.01 and 93.37%respectively.Type I diagnostic accordance rate was 89.66%,type II was 87.50%,type III was 84.62%and type IV was 82.14%.The total diagnosis coincidence rate was 86.18%.The diagnostic efficacy increased significantly by the combined method than by the temporal bone HRCT alone.CONCLUSION Temporal bone HRCT combined with pure tone audiometry is valuable in diagnosis of tympanosclerosis.It can provide theoretical basis for making optimal operation scheme in suspect tympanosclerosis patients.
出处
《中国耳鼻咽喉头颈外科》
CSCD
2016年第9期525-528,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
体层摄影术
螺旋计算机
颞骨
测听法
纯音
中耳
硬化
Tomography
Spiral Computed
Temporal Bone
Audiometry
Pure-Tone
Ear
Middle
Sclerosis
