Zhang Junbo, Zhong Zhen, Xiao Shuifang, Liu Yuhe, Zhen Zhen, Ren Lei, Zhang Lei
Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, 8# Xishiku Street, Western District, Beijing, 100034, China.
Eur Arch Otorhinolaryngol. 2018 Jan;275(1):53-57. doi: 10.1007/s00405-017-4772-8. Epub 2017 Oct 26.
Tubomanometry (TMM) is a relatively novel method for testing the eustachian tube (ET) function, which is speculated to be closely related to otitis media with effusion (OME). The purpose of this study is to explore the predictive power of TMM value for medication outcomes in adult acute OME. A cohort of 41 adult acute OME patients with 53 affected ears was studied retrospectively. All these patients completed a 2-week treatment including oral Myrtol Standardized Enteric capsules, nasal steroid, and oral antihistamine. The results showed that the response rate was 41.5% (22/53). The ratio of tympanometry C and TMM value differed significantly between responders and non-responders (P < 0.05), and the TMM value is the only predictive variable for treatment outcomes (P < 0.001, odds ratio 1.873). A ROC analysis of the TMM value for the treatment outcome showed that the area under the curve could achieve 0.773 (P < 0.001), while the optimal cutoff value calculated by Youden index was 1.5, with 72.7% sensitivity and 74.2% specificity. The response rate of ears with 2-6 TMM values could reach 66.7% (16/24), which was significantly higher than that of ears with TMM values 0-1, 20.7% (6/29) (P < 0.001). These findings showed that acute OME patients with a high TMM value and tympanometry C of the affected ear could potentially benefit from medication. The TMM value was an independent predictive factor of the treatment outcomes that could guide treatment decisions.
咽鼓管压力测定法（TMM）是一种相对新颖的检测咽鼓管（ET）功能的方法，据推测它与分泌性中耳炎（OME）密切相关。本研究的目的是探讨TMM值对成人急性OME药物治疗效果的预测能力。对41例患有53只患耳的成人急性OME患者进行了回顾性研究。所有这些患者均完成了为期2周的治疗，包括口服标准肠溶型桃金娘油胶囊、鼻用类固醇和口服抗组胺药。结果显示，有效率为41.5%（22/53）。反应者和无反应者之间鼓室导抗图C和TMM值的比率差异显著（P < 0.05），且TMM值是治疗效果的唯一预测变量（P < 0.001，优势比为1.873）。对治疗效果的TMM值进行ROC分析表明，曲线下面积可达0.773（P < 0.001），而由约登指数计算出的最佳截断值为1.5，灵敏度为72.7%，特异度为74.2%。TMM值为2 - 6的患耳有效率可达66.7%（16/24），显著高于TMM值为0 - 1的患耳，后者为20.7%（6/29）（P < 0.001）。这些发现表明，患耳TMM值高且鼓室导抗图为C型的急性OME患者可能从药物治疗中获益。TMM值是治疗效果的独立预测因素，可指导治疗决策。
