Dragicević Danijela, Vlaski Ljiljana, Komazec Zoran, Jović Rajko M
University ENT Clinic, Clinical Center of Vojvodina, Hajduk Veljkova 1, Novi Sad, Serbia.
Auris Nasus Larynx. 2010 Jun;37(3):281-5. doi: 10.1016/j.anl.2009.09.004. Epub 2009 Oct 28.
Otitis media with effusion (OME) is one of the commonest causes of acquired hearing loss in children with increasing incidence. In young children the diagnosis is restricted to clinical trials and tympanometry whereas evaluation of the auditory function is impossible due to noncompliance during pure tone audiometry. For this purpose, measurement of otoacoustic emissions, especially transient evoked ones (TEOAE), can be applied. The aim of this study is to evaluate the parameters of TEOAE in young children with OME prior and after surgery.
Prospective study included 50 children with OME, both sexes, aged 2-5 years. Preoperatively tympanometric examination was performed and TEOAE were recorded. Surgery was performed under general anesthesia and included myringotomy with/without ventilation tube insertion. Measurements of TEOAEs (correlation percentage, signal to noise ratio and amplitude) were repeated on the first and six day postoperatively as well as 6 weeks and 6 months postoperatively.
The preoperative TEOAEs were not recorded in 93.5%, with values of all TEOAE parameters being the most affected on highest frequencies. Significant changes of all TEOAE parameters were found 6 weeks postoperatively with further improvement 6 months postoperatively. Statistically highly significant difference of TEOAE between examinees with and without inserted ventilation tubes was established only in regard to preoperative results.
In small children with OME, application of TEOAEs in follow-up of surgical effects is a method of choice for hearing screening due to its objectivity, simplicity and ease of use even after insertion of ventilation tubes. Follow-ups of TEOAE correlation percentage and signal to noise ratio reflect the condition earlier than follow-ups of TEOAE amplitude.
分泌性中耳炎(OME)是儿童后天性听力损失最常见的原因之一,其发病率呈上升趋势。对于幼儿,诊断仅限于临床试验和鼓室图检查,而由于纯音听力测试时患儿不配合,无法评估其听觉功能。为此,可应用耳声发射测量,尤其是瞬态诱发耳声发射(TEOAE)。本研究的目的是评估OME幼儿手术前后TEOAE的参数。
前瞻性研究纳入了50例2至5岁的OME患儿,男女不限。术前进行鼓室图检查并记录TEOAE。在全身麻醉下进行手术,包括鼓膜切开术并酌情插入通气管。术后第1天和第6天以及术后6周和6个月重复测量TEOAE(相关百分比、信噪比和振幅)。
93.5%的患儿术前未记录到TEOAE,所有TEOAE参数值在最高频率时受影响最大。术后6周发现所有TEOAE参数有显著变化,术后6个月进一步改善。仅在术前结果方面,插入和未插入通气管的受检者之间TEOAE存在统计学上的高度显著差异。
对于患有OME的幼儿,TEOAE用于手术效果的随访是听力筛查的一种选择方法,因为它具有客观性、简单性且即使在插入通气管后也易于使用。TEOAE相关百分比和信噪比的随访比TEOAE振幅的随访更早反映病情。