Hassmann-Poznańska Elzbieta, Goździewski Artur, Piszcz Małgorzata, Zajaczkiewicz Hanna, Skotnicka Bozena
Klinika Otolaryngologii Dzieciqcej Uniwersytetu Medycznego w Białymstoku.
Otolaryngol Pol. 2010 Sep-Oct;64(5):307-12. doi: 10.1016/S0030-6657(10)70612-0.
The aim of the study is to analyze the relationship between otoscopic tympanic membrane abnormalities, results of impedanace and extended-high-frequency audiometry in subjects with history of treatment of secretory otitis media (SOM) and ventilation tube insertion.
97 subjects treated because of SOM were examined in years 1999-2000. Videootoscopic examinations, extended-high-frequency audiometry and tympanometry with ispilateral acoustic reflex were performed in each patient. The results were analysed in three groups: no otoscopic abnormalities (BZO), retraction pockets (KR) and atrophy and myringosclerosis (AM). The results were compared to otologicaly healthy control group in the same age.
The most common tympanic membrane abnormality were focal atrophy (64.7%) of ears and myringosclerosis (37.2%). Mean pure-tone audiometric threshold were significantly higher in groups KR and AM than in control and BZO groups. Low degree of positive correlation was found between the presence of myringosclerosis and atrophy and audiometric thresholds above 1 kHz. No such correlation was observed with the presence of retraction pockets. In the BZO group middle ear admittance was observed significantly higher than in control group. The absent ipsilateral stapedial reflex was observed in 10.8% ears in BZO group, 16.9% in AM and 33.3% in KR. No correlation was found between the parameters of tympanometric evaluation and results of extended-high-frequency audiometry.
In ears treated because of SOM with ventilation tube insertion the middle ear compliance is higher. In the presence of myringosclerosis and atrophy higher audiometric thresholds are observed. Tympanic membrane abnormalities have been more clearly indicated by the absent ipsilateral stapedial reflex than tympanometry.
本研究旨在分析分泌性中耳炎（SOM）治疗史及鼓膜置管患者的耳镜检查鼓膜异常、声阻抗结果与扩展高频听力测定结果之间的关系。
1999年至2000年期间对97例因SOM接受治疗的患者进行了检查。对每位患者进行了视频耳镜检查、扩展高频听力测定及同侧声反射鼓室图检查。结果分为三组进行分析：无耳镜异常（BZO）、内陷袋（KR）以及萎缩和鼓膜硬化（AM）。将结果与同年龄的耳科健康对照组进行比较。
最常见的鼓膜异常是耳部局灶性萎缩（64.7%）和鼓膜硬化（37.2%）。KR组和AM组的平均纯音听力阈值显著高于对照组和BZO组。鼓膜硬化和萎缩的存在与1kHz以上听力阈值之间存在低度正相关。内陷袋的存在未观察到此类相关性。BZO组的中耳导纳显著高于对照组。BZO组10.8%的耳、AM组16.9%的耳及KR组33.3%的耳同侧镫骨肌反射消失。鼓室图评估参数与扩展高频听力测定结果之间未发现相关性。
在因SOM接受鼓膜置管治疗的耳中，中耳顺应性较高。存在鼓膜硬化和萎缩时，听力阈值较高。同侧镫骨肌反射消失比鼓室图更能清楚地显示鼓膜异常。
