Department of Otorhinolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Department of Otorhinolaryngology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China.
Int J Pediatr Otorhinolaryngol. 2021 Jan;140:110496. doi: 10.1016/j.ijporl.2020.110496. Epub 2020 Nov 16.
This study aimed to investigate the characteristics of the wideband absorbance (WBA) of acoustic energy in children (3-7 years old) with otitis media with effusion (OME) under environmental ear-canal air pressure and tympanometric peak pressure and to determine the diagnostic value of the acoustic energy absorption rate (AR) in OME at different frequencies.
A total of 178 children aged 3-7 years were enrolled in the study between April and October 2018. They were separated into two groups: those with middle ear effusion were placed in the OME group (n = 80; 136 ears), while those without OME (n = 98; 182 ears) were placed in the control group. A WBA test was performed on the children in both groups under environmental ear-canal pressure and tympanometric peak pressure to analyze the changing characteristics of the AR value within the 0.226-8 kHz range.
Under ambient ear-canal air pressure, the AR of the OME group in each frequency band was significantly lower than that of the control group (P < 0.01). Under tympanometric peak pressure, the AR of the OME group in most frequencies was also significantly lower than those of the control group (P < 0.01) except in the 2-2.5 kHz range. The area under the receiver operating characteristic curve (AUROC) was highest at 0.47-1.03 kHz: 0.96 and 0.94 at ambient ear-canal pressure and tympanometric peak pressure, respectively. Of the single frequency points, those at 0.65, 0.67, 0.69, 0.71, and 0.73 kHz had a higher AUROC value (0.96-0.97) under both ambient ear-canal air pressure and tympanometric peak pressure. The difference in the AUROC values of the two pressure conditions was not statistically significant (P < 0.01).
Overall, WBA is an effective method of diagnosing OME in children. The frequency band with the most predictive value of AR for OME is 0.47-1.03 kHz. Middle ear effusion can be quickly identified by observing AR values in this frequency range, which provides a diagnostic basis for OME.
本研究旨在探讨儿童(3-7 岁)在环境耳腔气压和鼓室压峰压下,中耳积液(OME)的宽带吸声(WBA)特性,并确定不同频率下中耳声能吸收率(AR)的诊断价值。
2018 年 4 月至 10 月期间,共纳入 178 名 3-7 岁儿童,将其分为中耳积液组(OME 组,n=80;136 耳)和对照组(n=98;182 耳)。对两组儿童在环境耳腔气压和鼓室压峰压下进行 WBA 测试,分析 0.226-8 kHz 范围内 AR 值的变化特征。
在环境耳腔气压下,OME 组各频段的 AR 明显低于对照组(P<0.01)。在鼓室压峰压下,OME 组在大多数频率下的 AR 也明显低于对照组(P<0.01),除了在 2-2.5 kHz 范围内。在环境耳腔气压和鼓室压峰压下,曲线下面积(AUROC)最高的频率范围为 0.47-1.03 kHz:分别为 0.96 和 0.94。在单一频率点中,0.65、0.67、0.69、0.71 和 0.73 kHz 时的 AUROC 值较高(0.96-0.97),环境耳腔气压和鼓室压峰压下均如此。两种压力条件下 AUROC 值的差异无统计学意义(P<0.01)。
总之,WBA 是一种有效的儿童 OME 诊断方法。对 AR 预测 OME 最有价值的频段是 0.47-1.03 kHz。通过观察该频率范围内的 AR 值,可快速识别中耳积液,为 OME 提供诊断依据。