梅尼埃病患者宽频声导抗吸收率的特征

李姝娜; 沈敏; 陈向平; 沈佳丽; 杨军

doi:10.13201/j.issn.1001-1781.2019.03.010

梅尼埃病患者宽频声导抗吸收率的特征

- 上海交通大学医学院附属新华医院耳鼻咽喉头颈外科上海交通大学医学院耳科学研究所上海市耳鼻疾病转化医学重点实验室(上海, 200092)
基金项目:
国家自然科学基金青年项目 (No:81600799)

国家自然基金面上项目 (No:81470689)

上海交通大学科技创新专项资金多学科交叉项目 (No:ZH2018ZDA11)

详细信息

通讯作者: 杨军,E-mail:yangjun@xinhuamed.com.cn

中图分类号: R764.33

收稿日期: 2018-12-05

Acoustic absorbance characteristics of wideband tympanometry in patients with Meniere’s disease

- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine; Institute of Ophthalmology, School of Medicine, Shanghai Jiaotong University; Shanghai key Laboratory of Ear and Nose Disease Transformation, Shanghai, 200092, China

More Information

Corresponding author: YANG Jun, E-mail: yangjun@xinhuamed.com.cn

Received Date: 05 December 2018

摘要

摘要: 目的:探讨宽频声导抗吸收率在梅尼埃病中的特征。方法:对36例单侧梅尼埃病患者进行宽频声导抗、纯音测听、耳蜗电图和内听道MRI检查,并收集39例正常成年人宽频声导抗结果进行对比。从宽频声导抗数据库中调出鼓室图峰压值对应的各频率吸收率数值,计算吸收率相对面积;计录耳蜗电图中总和电位和动作电位的比值(-SP/AP);鼓室内注射钆造影剂后行内听道核磁共振,判断有无膜迷路积水。使用配对t检验对单侧梅尼埃病患者吸收率面积、吸收率峰值进行比较;使用单因素方差分析对各期患耳吸收率面积、吸收率峰值以及双耳间吸收率面积差值进行比较。结果:单侧梅尼埃病患者双耳间吸收率面积患侧均大于健侧,差异有统计学意义;双耳间吸收率峰值无显著差异;各期梅尼埃病患耳间吸收率峰值、吸收率面积及双耳间吸收率面积差值均无显著差异;正常成年人与单侧梅尼埃病患者双耳吸收率面积差值无显著差异。单侧梅尼埃病患耳内听道钆造影显示内淋巴积水比例为95.24%,耳蜗电图中-SP/AP>0.4为61.11%。结论:单侧梅尼埃病患者宽频声导抗患侧吸收率相对面积大于健侧,敏感性高,但非特异性。
- 梅尼埃病 /
- 宽频声导抗 /
- 声吸收率 /
- 耳蜗电图 /
- 核磁共振
Abstract: Objective:To study acoustic absorbance characteristics of wideband tympanometry in patients with unilateral Meniere's disease.Method:Acoustic absorbance were detected using wideband tympanometry in 36 patients with unilateral Meniere's disease and 39 control subjects excluding inner ear and middle ear disease.All patients with Meniere's disease underwent electrocochleography, gadolinium contrast internal auditory canal MRI, pure tone test.The integral area formed by the absorbance curve on peak pressure and x-axis (frequency) was calculated.Student's t-test was used to compare integral areas difference of 2 ears in Meniere's disease patients and control group.Result:The integral area of absorbance was greater in affected side than unaffected side and there was no difference in peak values of absorbance between 2 ears in Meniere's disease patients.There was no significant difference in areas between Meniere's disease in different grade (P>0.05).Peak value of absorbance and difference value of absorbance were not significant between Meniere's disease patients and normal control.Only 61.11% Meniere's disease patients showed-SP/AP>0.4 and 95.24%showed endolymphatic hydrops in affected side.Conclusion:Affected side in patients with Meniere's disease showed higher integral area of absorbance than other side, which is high sensitive but not specific.
- Meniere's disease /
- wideband tympanometry /
- absorbance /
- electrocochleography /
- MRI

HTML全文

参考文献(12)

[1]	SANFORD C A, HUNTER L L, FEENEY M P, et al.Wideband Acoustic Immittance:Tympanometric Measures[J].Ear Hear, 2013, 34 Suppl 1:65S-71S.
[2]	DEMIR E, AFACAN N N, CELIKER M, et al.Can Wideband Tympanometry Be Used as a Screening Test for Superior Semicircular Canal Dehiscence[J]?Clin Exp Otorhinolaryngol, 2018,[Epub ahead of print]
[3]	LIU Y, JIA H, SHI J, et al.Endolymphatic hydrops detected by 3-dimensional fluid-attenuated inversion recovery MRI following intratympanic injection of gadolinium in the asymptomatic contralateral ears of patients with unilateral Ménière's disease[J].Med Sci Monit, 2015, 21:701-707.
[4]	ZOU J, PYYKKO I, BJELKE B, et al.Communication between the perilymphatic scalae and spiral ligament visualized by in vivo MRI[J].Audiol Neurootol, 2005, 10:145-152.
[5]	AITHAL S, KEI J, AITHAL V, et al.Normative Study of Wideband Acoustic Immittance Measures in Newborn Infants[J].J Speech Lang Hear Res, 2017, 60:1417-1426.
[6]	HUNTER L L, KEEFE D H, FEENEY M P, et al.Wideband acoustic immittance in children with Down syndrome:prediction of middle-ear dysfunction, conductive hearing loss and patent PE tubes[J].Int J Audiol, 2017, 56:622-634.
[7]	SUN X M.Wideband Acoustic Immittance:Normative Study and Test-Retest Reliability of Tympanometric Measurements in Adults[J].J Speech Lang Hear Res, 2016, 59:819-834.
[8]	王素菊, 商莹莹, 倪道凤, 等.中耳功能正常与异常婴儿的宽频声导抗能量吸收率特性研究[J].听力学及言语疾病杂志, 2016, 24 (6):539-544.
[9]	郝文洋, 商莹莹, 倪道凤, 等.正常新生儿宽频声导抗能量吸收率及其可重复性研究[J].听力学及言语疾病杂志, 2016, 24 (1):10-14.
[10]	DEVAIAH A K, ATOR G A.Clinical indicators useful in predicting response to the medical management of Meniere's disease[J].Laryngoscope, 2000, 110:1861-1865.
[11]	李忆楠, 冯艳梅.耳蜗电图在梅尼埃病诊断中的作用[J].听力学及言语疾病杂志, 2018, 26 (6):227-230.
[12]	陈才军, 陈正侬, 路文, 等.MRI造影所见耳蜗积水与梅尼埃病分级的相关性研究[J].临床耳鼻咽喉头颈外科杂志, 2017, 31 (8):623-626.