Durante Alessandra Spada, Santos Mayara, Roque Nayara M C de F, Gameiro Marcella S, Almeida Katia de, Sousa Neto Osmar Mesquita de
Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Curso de Fonoaudiologia, São Paulo, SP, Brazil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Curso de Fonoaudiologia, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2019 Mar-Apr;85(2):193-198. doi: 10.1016/j.bjorl.2017.12.006. Epub 2018 Jan 10.
Tympanometry is currently the most frequently used tool for assessing the status of the middle ear, commonly assessed using a single 226Hz tone. However, the use of the Acoustic Immittance Measures with a wideband stimulus is a promising high-resolution evaluation, especially in individuals known to have middle ear alterations, such as Down syndrome patients.
The aim of this study was to analyze the acoustic absorbance measurements in children with Down syndrome.
Cross-sectional study, approved by the institution's ethics committee. Data were collected from 30 children, with a mean age of 8.4 years, 15 with Down syndrome (DS-study group) and 15 children with typical development and no hearing complaints (control group). Energy absorbance was measured at frequencies of 226-8000Hz at ambient pressure and at peak pressure as a function of frequency using TITAN equipment. Statistical analysis was performed using the established level of statistical significance of 5%.
With the 226Hz probe tone, 30 ears of the control group and 22 of the study group exhibited Type A tympanograms, whereas Type B was observed in eight children in the study group. The mean acoustic absorbance ratio of the study group was lower than that of the control group at frequencies centered at 2520Hz (p=0.008) for those with normal tympanometry results, and 226-4000Hz (p<0.03) for those with a Type B tympanometry curve.
The low energy absorption in the presence of normal tympanograms in children with Down syndrome may suggest middle ear abnormalities.
鼓室导抗测试法是目前评估中耳状态最常用的工具，通常使用单一的226Hz纯音进行评估。然而，使用宽带刺激的声导抗测量是一种很有前景的高分辨率评估方法，特别是对于已知有中耳改变的个体，如下唐氏综合征患者。
本研究的目的是分析唐氏综合征患儿的声吸收测量结果。
横断面研究，经机构伦理委员会批准。收集了30名儿童的数据，平均年龄8.4岁，其中15名患有唐氏综合征（唐氏综合征研究组），15名发育正常且无听力问题的儿童（对照组）。使用TITAN设备在环境压力和峰值压力下，在226 - 8000Hz频率下测量能量吸收，并将其作为频率的函数。采用5%的既定统计学显著性水平进行统计分析。
使用226Hz探测音时，对照组的30只耳和研究组的22只耳呈现A型鼓室导抗图，而研究组有8名儿童呈现B型。对于鼓室导抗测试结果正常的儿童，研究组在以2520Hz为中心的频率处的平均声吸收比低于对照组（p = 0.008）；对于鼓室导抗图为B型的儿童，在226 - 4000Hz频率处（p < 0.03）也是如此。
唐氏综合征患儿在鼓室导抗图正常的情况下能量吸收较低，这可能提示中耳异常。
