Muderris Togay, Yazıcı Alper, Bercin Sami, Yalçıner Gökhan, Sevil Ergun, Kırıs Muzaffer
Ataturk Education and Research Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Ankara, Turkey.
Int J Pediatr Otorhinolaryngol. 2013 Oct;77(10):1771-4. doi: 10.1016/j.ijporl.2013.08.019. Epub 2013 Aug 28.
Acoustic reflectometry is a technique based on a sonar that enables the diagnosis of middle ear effusion. We aimed to evaluate the accuracy and diagnostic value of consumer type acoustic reflectometry device for determining middle ear effusion in children.
Acoustic reflectometry and tympanometries of 84 children, from 3 to 14 years of age, were done the day before they underwent adenoidectomy/adenotonsillectomy and myringotomy ± ventilation tube insertion under general anesthesia in the operating room with diagnosis of middle ear effusion. Their test results and the results of myringotomies, which is the golden standard technique in determination of otitis media with effusion, were compared. Specificity, sensitivity, positive and negative predictive values of both instruments in detecting middle ear fluid were determined.
Otitis media with effusion was detected in 106 ears (63.1%) during myringotomy. The sensitivity and specificities of acoustic reflectometry were found to be 83.33% and 68.18%, and tympanometry were 84.48% and 84.62%, respectively. The positive predictive value was 75.12% for acoustic reflectometry and 88.56% for tympanometry, and negative predictive values of acoustic reflectometry and tympanometry were 87.66% and 89.2%, respectively. The sensitivity of the AR was comparable to tympanometry (p > 0.01), however the specificity, PPV and NPV of AR were lower than tympanometry (p < 0.001).
Consumer type acoustic reflectometry is highly sensitive, objective and easy to perform technique for detecting otitis media with effusion, and it may help us to diagnose otitis media with effusion in early stages if used by family practitioners or parents.
声反射测量法是一种基于声呐的技术，可用于诊断中耳积液。我们旨在评估消费型声反射测量设备在诊断儿童中耳积液方面的准确性和诊断价值。
对84名3至14岁的儿童在手术室接受腺样体切除术/腺样体扁桃体切除术及鼓膜切开术±置管术（均在全身麻醉下进行）前一天进行声反射测量和鼓室图检查，这些儿童均被诊断为中耳积液。将他们的测试结果与鼓膜切开术的结果进行比较，鼓膜切开术是确定积液性中耳炎的金标准技术。确定了两种仪器在检测中耳积液方面的特异性、敏感性、阳性和阴性预测值。
鼓膜切开术中发现106耳（63.1%）存在积液性中耳炎。声反射测量法的敏感性和特异性分别为83.33%和68.18%，鼓室图检查的敏感性和特异性分别为84.48%和84.62%。声反射测量法的阳性预测值为75.12%，鼓室图检查的阳性预测值为88.56%，声反射测量法和鼓室图检查的阴性预测值分别为87.66%和89.2%。声反射测量法的敏感性与鼓室图检查相当（p>0.01），然而声反射测量法的特异性、阳性预测值和阴性预测值均低于鼓室图检查（p<0.001）。
消费型声反射测量法是一种检测积液性中耳炎高度敏感、客观且易于操作的技术，如果家庭医生或家长使用，可能有助于我们早期诊断积液性中耳炎。
