226 Hz和1 000 Hz鼓室声导纳在不同年龄婴幼儿分泌性中耳炎应用探讨

刘辉; 莫玲燕; 吕静; 陈雪静; 陈静; 姬晨; 陈雪清; 刘志成

doi:10.13201/j.issn.1001-1781.2014.10.009

226 Hz和1 000 Hz鼓室声导纳在不同年龄婴幼儿分泌性中耳炎应用探讨

- 1. 首都医科大学生物医学工程学院(北京, 100730);
- 2. 首都医科大学附属北京同仁医院, 北京市耳鼻咽喉科研究所, 耳鼻咽喉头颈科学教育部重点实验室(首都医科大学)
基金项目:
北京市卫生系统高层次卫生技术人才培养计划基金（No：2009-3-29）；首都医科大学基础-临床科研合作基金重点项目（No：12JL12）；首都卫生发展科研专项项目（No：2011-1017-01）；资助卫生行业科研专项（No：201202001）；卫生行业科研专项资助项目（No：201202001）

详细信息

通讯作者: 刘志成,E-mail:zcliu@ccmu.edu.cn

中图分类号: R764.21

收稿日期: 2013-09-30

A comparison of 226 Hz and 1 000 Hz tympanometryin diagnosis of infants otitis media effusion

- 1. School of Biomedical Engineering, Capital Medical University, Beijing, 100730, China;
- 2. Beijing Tong Ren Hospital Affiliated with Capital Medical University, Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Ministry of Education

More Information

Corresponding author: LIU Zhicheng, E-mail: zcliu@ccmu.edu.cn

Received Date: 30 September 2013

摘要

摘要: 目的：以影像学检查为诊断分泌性中耳性的标准，分析不同年龄段分泌性中耳炎常婴幼儿226 Hz和1 000 Hz 2种探测音鼓室声导纳曲线类型分布特点和趋势，比较2种方法在敏感度和特异度，为临床诊断提供依据。方法：经颞骨薄层CT证实为分泌性中耳炎婴幼儿177例（226耳），中耳结构正常的婴幼儿158例（266耳），年龄1~60个月。根据年龄分为6组，分别为0~6月龄组，6~12月龄组，12~18月龄组，18~24月龄组，24~36月龄组，36~60月龄组，分别进行226 Hz和1 000 Hz探测音鼓室声导纳测试。用配对χ² 检验对不同年龄组受试儿童两种声导纳测试法结果进行检验，并用ROC方法分析2种方法的敏感度和特异度。结果：分泌性中耳炎婴幼儿各组226 Hz鼓室声导纳异常检出率分别为21.1%、35.2%、46.9%、42.0%、62.5%及68%，1 000 Hz鼓室声导纳异常检出率分别为94.7%、98.1%、96.9%、91.2%、95.8%及88.0%。中耳功能正常婴幼儿，226 Hz鼓室声导纳正常型检出率分别为95.1%、88.6%、85.1%、93.3%、88.5%及93.5%，1 000 Hz鼓室声导纳正常型检出率分别是为87.8%、94.3%、89.4%、95.6%、94.2%及97.8%。2种测试方法对分泌性中耳炎的检出率在36月龄以下差异有统计学意义，2种测试方法的敏感度和特异度在0~36个月差异有统计学意义，36个月以上差异无统计学意义。结论： 36月龄以下婴幼儿探测分泌性中耳炎应以1 000 Hz鼓室声导纳为主，36~60月龄幼儿应同时测试226及1 000 Hz鼓室声导纳。以单峰型和双峰型1 000 Hz鼓室声导纳作为分泌性中耳炎的正常标准，具有很高的可靠性和实用性。
- 颞骨薄层CT /
- 婴幼儿 /
- 鼓膜 /
- 中耳炎积液
Abstract: Objective: To provide a clinical reference by comparing the conventional 226 Hz tympanometry with 1000 Hz tympanometry in two groups of young children with otitis media effusion evidenced by CT scan.Method: One hundred and seventy-seven young children (226 ears),from 1 to 60 months, with otitis media effusion were involved in this study. They were divided into six groups by age:0-6 months group, 6-12 months group, 12-18 months group, 18-24 months group, 24-36 months group, 36-60 months group. They were tested with tympanometry of 2 probe-tones of 226 and 1 000 Hz. Type A tympanogram was defined as a normal middle ear function in 226 Hz and single-or double-peak in 1 000 Hz tympanometry.One hundred and fifty-eight normal young children (266 ears) were selected as control group. The results were analysed with Chi square test。Receiver operator characteristic (ROC) analysis was performed to evaluate the two methods. Result: In the young children with otitis media effusion, the detection rate of 226 Hz tympanogram in six groups was 21.1%、35.2%、46.9%、42%、62.5% and 68% respectively, while 94.7%、98.1%、96.9%、91.2%、95.8% and 88% respectively in 1 000 Hz tympanogram. In the young children with normal middle ear function, the detection rate of 226 Hz tympanogram in six groups was 95.1%、88.6%、85.1%、93.3%、88.5% and 93.5%,while 87.8%、94.3%、89.4%、95.6%、94.2% and 97.8% respectively in 1 000 Hz tympanogram. The detection rate was significantly different between 226 and 1 000 Hz tympanogram in the young children under 36-month old. Conclusion: A single-or double-peak 1000 Hz tympanometric patterns as normal criteria was a simple way to evaluate young children`s middle ear function. 1 000 Hz tympanometry should be given priority to the children within 36-month old in detection middle ear function,the 226 and 1 000 Hz tympanometry should be done at the same time within 36-60 months old.
- temporal bone CT /
- infants /
- tympanometry /
- otitis media effusion

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参考文献(13)

[1]	商莹莹, 倪道凤,刘世琳. 低频和高频探测音鼓室声导抗测试在婴儿中耳功能诊断中的作用[J].中华耳鼻咽喉头颈外科杂志, 2006, 41(5):326-330.
[2]	KILIC A, BAYSAL E, KARATAS E, et al. The role of high frequency tympanometry in newborn hearing screening programme[J]. Eur Rev Med Pharmacol Sci, 2012,16:220-223.
[3]	MAZLAN R, KEI J, HICKSON L, et al. Test-retest reproducibility of the 1000 Hz tympanometry test in newborn and six-week-old healthy infants[J]. Int J Audiol, 2010, 49:815-822.
[4]	KEI J, MAZLAN R, HICKSON L, et al. Measuring middle ear admittance in newborns using 1000 Hz tympanometry:a comparison of methodologies[J]. J Am Academy Audiol, 2007, 18:739-748.
[5]	MARGOLIS R H, BASS-RINGDAHL S, HANKS W D, et al. Tympanometry in newborn infants——1 kHz norms[J]. J Am Academy Audiol, 2003, 14:383-392.
[6]	SHAHNAZ N, MIRANDA T,POLKA L. Multifrequency tympanometry in neonatal intensive care unit and well babies[J]. J Am Academy Audiol, 2008, 19:392-418.
[7]	陈文霞,许政敏. 声导抗测试在婴儿中的应用[J].听力学及言语疾病杂志, 2007,15(6):428-431.
[8]	吕静, 莫玲燕, 刘辉, 等. 颞骨CT正常儿童1 kHz鼓室声导纳特征[J].听力学及言语疾病杂志, 2011, 19(4):315-319.
[9]	CHIANESE J, HOBERMAN A, PARADISE J L, et al. Spectral gradient acoustic reflectometry compared with tympanometry in diagnosing middle ear effusion in children aged 6 to 24 months[J]. Archives Pediatr Adolescent Medicine, 2007,161:884-888.
[10]	KEI J, ALLISON-LEVICK J, DOCKRAY J, et al. High-frequency (1000 Hz) tympanometry in normal neonates[J]. J Am Academy Audiol, 2003,14:20-28.
[11]	LIU Z Q, YANG K,HUANG Z W. Tympanometry in infants with middle ear effusion having been identified using spiral computerized tomography[J]. Am J Otol, 2010, 31:96-103.
[12]	ALAENS J, LUTS H,WOUTERS J. Evaluation of middle ear function in young children:Clinical guidelines for the use of 226-and 1,000-hz Tympanometry[J]. Otol Neurotol, 2007, 28:727-732.
[13]	BALDWIN M. Choice of probe tone and classification of trace patterns in tympanometry undertaken in early infancy[J]. Inter J Audiol, 2006, 45:417-427.