Miehe Jacob, Mogensen Simon, Lyhne Nina, Skals Regitze, Hougaard Dan D
Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
Eur Arch Otorhinolaryngol. 2022 Apr;279(4):1831-1841. doi: 10.1007/s00405-021-06882-7. Epub 2021 May 19.
The main purpose of this study was to investigate the usefulness of wide band tympanometry (WBT) as a diagnostic tool for Ménière's disease (MD) by comparing differences in absorbance measures between normal hearing ears and patient diagnosed with MD.
We conducted a retrospective case-control study. From a cohort of 116 patients diagnosed with Ménière disease, 52 MD patients and 99 normal hearing adults with no history of otological disease served as subjects. Wideband tympanometry was conducted using at Titan Impedance module and audiometry was performed with a MADSEN Astera. Mean energy absorbance curves with 95% confidence intervals were computed across cases with MD and controls in the frequency range 226-8000 Hz. An overall test for difference between curves of cases and controls was calculated by multivariate analysis of variance.
The MD group and the subpopulations of MD patients who fulfilled the International criteria for MD showed a statistically significant lower absorbance at tympanic peak pressure compared to the control group (p < 0.001). No overlap of confidence intervals between mean curves was found within the frequency range of 2000-4000 Hz.
Absorbance measures obtained by WBT were able to distinguish between MD ears and normal ears within the frequency range of 2000-4000 Hz. The results indicate that WBT potentially could be a useful and simple non-invasive diagnostic tool for MD. However, more research on the association between absorbance measures and inner ear pathologies is needed.
本研究的主要目的是通过比较正常听力耳朵与被诊断为梅尼埃病(MD)的患者之间的吸收率测量差异,来研究宽带鼓室导抗图(WBT)作为梅尼埃病诊断工具的有效性。
我们进行了一项回顾性病例对照研究。从116名被诊断为梅尼埃病的患者队列中,选取52名MD患者和99名无耳科疾病史的正常听力成年人作为研究对象。使用Titan阻抗模块进行宽带鼓室导抗图检查,并用MADSEN Astera进行听力测定。计算MD患者和对照组在226 - 8000Hz频率范围内的平均能量吸收率曲线及其95%置信区间。通过多变量方差分析计算病例组和对照组曲线之间差异的总体检验。
与对照组相比,MD组以及符合MD国际标准的MD患者亚组在鼓膜峰值压力下的吸收率在统计学上显著更低(p < 0.001)。在2000 - 4000Hz频率范围内,平均曲线的置信区间没有重叠。
通过WBT获得的吸收率测量能够在2000 - 4000Hz频率范围内区分MD耳朵和正常耳朵。结果表明,WBT可能是一种有用且简单的MD无创诊断工具。然而,需要对吸收率测量与内耳病理之间的关联进行更多研究。