Jaisinghani V J, Hunter L L, Li Y, Margolis R H
Lion's-5M Hearing Foundation, University of Minnesota, Minneapolis, USA.
Laryngoscope. 2000 Oct;110(10 Pt 1):1726-30. doi: 10.1097/00005537-200010000-00031.
To perform quantitative analysis of pathological changes in the tympanic membrane using video-otoscopic images.
Prospective case-control study.
Forty-two ears of children with chronic otitis media with effusion (OME) and 15 ears of normal children were included in this study. Tympanic membrane images were captured and digitized using a Welch-Allyn (Skaneatales Falls, NY) VDX-300 Illumination and Imaging system with S-VHS input to a MIRO DC 30 (Pinnacle Systems, Mountain View, CA) visual board in a Power PC-based computer. These images were visualized and recorded during static and pneumatic pressure changes. Quantitative analysis of tympanic membrane disease was performed using Image Pro Plus Imaging software (Media Cybernetics, Del Mar, CA). The measurements included area of the tympanic membrane and its quadrants, area of tympanic membrane involved by disease, angle formed at the umbo, and length of the malleus versus vertical length of the tympanic membrane.
Tympanosclerosis was present in 57% of ears and occurred most frequently in the anteroinferior quadrant, but the maximum area of involvement was in the posteroinferior quadrant. The ratio of the angles formed at the umbo was significantly greater (P = .01) for the OME group compared with the control group. The ratio of the length of the umbo and the vertical length of the tympanic membrane was almost identical for the OME and the control groups (P = .4).
Videootoscopic images can be used for quantitative analysis of tympanic membrane disease. The ratio of the posterior angle to the anterior angle formed at the umbo seems to be a more reliable indicator of post otitis media than is a reduced length of the long process of malleus.
利用视频耳镜图像对鼓膜的病理变化进行定量分析。
前瞻性病例对照研究。
本研究纳入了42例患有分泌性中耳炎（OME）的儿童的耳以及15例正常儿童的耳。使用Welch-Allyn（纽约州斯卡奈特勒斯福尔斯）VDX-300照明和成像系统采集鼓膜图像并进行数字化处理，该系统通过S-VHS输入到基于Power PC的计算机中的MIRO DC 30（加利福尼亚州山景城品尼高系统公司）视觉板上。在静态和气压变化过程中对这些图像进行可视化和记录。使用Image Pro Plus成像软件（加利福尼亚州德尔马媒体细胞公司）对鼓膜疾病进行定量分析。测量内容包括鼓膜及其象限的面积、疾病累及的鼓膜面积、在鼓膜脐部形成的角度以及锤骨长度与鼓膜垂直长度的比值。
57%的耳存在鼓室硬化，最常发生在前下象限，但受累的最大面积在后下象限。与对照组相比,OME组在鼓膜脐部形成的角度比值显著更大（P = 0.01）。OME组和对照组的鼓膜脐部长度与鼓膜垂直长度的比值几乎相同（P = 0.4）。
视频耳镜图像可用于鼓膜疾病的定量分析。与锤骨长突长度缩短相比，鼓膜脐部形成的后角与前角的比值似乎是中耳炎后更可靠的指标。
