Koivunen P, Uhari M, Laitakari K, Alho O P, Luotonen J
Department of Otolaryngology, University of Oulu, Finland.
Ear Hear. 2000 Jun;21(3):212-7. doi: 10.1097/00003446-200006000-00004.
To examine otoacoustic emission and tympanometric findings in children with surgically confirmed middle ear effusion (MEE).
A total of 102 children aged 0.7 to 11.4 yr undergoing surgery because of otitis media were included in the study. A tympanometric examination and transient evoked otoacoustic emission (TEOAE) measurement were performed on each ear before myringotomy. MEE was aspirated, weighed and classified as mucoid or nonmucoid. TEOAE measurements were compared with the quantity and quality of MEE and to the tympanometric findings.
Fifty (72%) ears out of the 65 ears containing effusion showed reduced TEOAE. The quantity of effusion was associated significantly (p < 0.001) with the TEOAE responses, and mucoid effusion reduced the emissions more than nonmucoid. The sensitivity of tympanometry in identifying the ears without recordable TEOAE was 73% and the specificity 81%.
MEE results in a significant reduction in TEOAEs even when the effusion is nonmucoid. This suggests that transmission of acoustic energy to and from the middle ear is altered in children experiencing any form of otitis media with effusion.
研究经手术确诊为中耳积液（MEE）患儿的耳声发射及鼓室图检查结果。
本研究纳入了102例因中耳炎接受手术的0.7至11.4岁儿童。在鼓膜切开术前，对每只耳朵进行鼓室图检查和瞬态诱发耳声发射（TEOAE）测量。抽取中耳积液，称重并分为黏液样或非黏液样。将TEOAE测量结果与中耳积液的量和性质以及鼓室图检查结果进行比较。
65只存在积液的耳朵中，有50只（72%）的TEOAE降低。积液量与TEOAE反应显著相关（p < 0.001），黏液样积液比非黏液样积液对耳声发射的抑制作用更强。鼓室图检查在识别无记录TEOAE的耳朵时，敏感性为73%，特异性为81%。
即使积液为非黏液样，中耳积液也会导致TEOAE显著降低。这表明，在患有任何形式的分泌性中耳炎的儿童中，中耳内外声能的传递发生了改变。
