Doyle William J, Winther Birgit, Alper Cuneyt
Department of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Auris Nasus Larynx. 2009 Feb;36(1):20-5. doi: 10.1016/j.anl.2008.03.004. Epub 2008 May 14.
Tympanometry is a relatively simple method to assess middle ear (ME) status and pressure. Daily, serial tympanometric measurements may contain information on the constitutional efficiency of Eustachian tube function (ETF). A study was conducted to determine family compliance with an effort-intensive protocol that requires daily tympanometry done on each child, daily symptom recording by a parent and weekly visits with study personnel and to abstract measures that summarize the data as they relate to ETF.
Longitudinal 6-month, daily follow-up on 249 children from 123 families by parent-recorded bilateral tympanometry and cold-like illnesses.
Study attrition was minimal with 90% of the enrolled families completing 90% of the study period. Parental compliance with daily tympanometry was less. Overall, 67% of the families were 80% compliant and 51% were 90% compliant. Two measures (aMEP, average middle ear pressure; vMEP, standard deviation of MEP) were evaluated for summaries of the longitudinal tympanometric results. These measures were not bilaterally independent or mutually independent and were affected by cold-burden and age. The best summary measure of constitutional ET efficiency may be a dimensional map of vMEP on aMEP with subsequent subdivision of the dimensional space into zones with functional interpretations.
Long-term studies that require daily parental recording of tympanometry and the presence/absence of cold-like illness are feasible. It is expected that compliance with the required procedures can be increased substantially by pre-selection of candidate families. Preliminary data analyses suggest that the longitudinal tympanometric data contains important information on constitutional ETF.
鼓室导抗图是评估中耳(ME)状态和压力的一种相对简单的方法。每日进行的系列鼓室导抗测量可能包含有关咽鼓管功能(ETF)结构效率的信息。本研究旨在确定家庭对一项需要对每个孩子每日进行鼓室导抗测量、家长每日记录症状以及每周与研究人员进行随访的高强度方案的依从性,并提取能够总结与ETF相关数据的测量指标。
对来自123个家庭的249名儿童进行为期6个月的纵向每日随访,由家长记录双侧鼓室导抗图和类似感冒的疾病情况。
研究损耗极小,90%登记入组的家庭完成了90%的研究期。家长对每日鼓室导抗测量的依从性较低。总体而言,67%的家庭依从性达到80%,51%的家庭依从性达到90%。对两个测量指标(平均中耳压力aMEP;中耳压力标准差vMEP)进行评估,以总结纵向鼓室导抗测量结果。这些指标并非双侧独立或相互独立,且受感冒负担和年龄影响。对结构咽鼓管效率的最佳总结指标可能是vMEP在aMEP上的维度图,随后将维度空间细分为具有功能解释的区域。
要求家长每日记录鼓室导抗图以及类似感冒疾病的有无情况的长期研究是可行的。预计通过对候选家庭进行预先筛选,可以大幅提高对所需程序的依从性。初步数据分析表明,纵向鼓室导抗测量数据包含有关结构ETF的重要信息。