Department of Otolaryngology- Head and Neck Surgery, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal Do Rio Grande Do Sul (UFRGS), Centro de Otite Média Do, Brazil.
Department of Otolaryngology- Head and Neck Surgery, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal Do Rio Grande Do Sul (UFRGS), Centro de Otite Média Do, Brazil.
Int J Pediatr Otorhinolaryngol. 2021 Aug;147:110784. doi: 10.1016/j.ijporl.2021.110784. Epub 2021 May 23.
Owing to the limited literature demonstrating the correlation between the degree of severity of retractions and the degree of hearing loss in children and adults, the study aimed to compare the differences in the location, the severity, and the air-bone gap (ABG) of tympanic membrane (TM) retractions in children and adults.
Cross-sectional study, in a tertiary hospital. Consecutive patients with moderate or severe TM retractions (661 ears) between August 2000 and January 2019 were evaluated. The average age (mean ± standard deviation) was 11.7 ± 3.3 years among pediatric patients (42.4%) and 46.4 ± 5 years among adults (57.6%). Video-otoscopy and pure tone audiometry were performed in all patients. The main outcome measures were the locations of retractions, their prevalence, and their severity; ABG thresholds measured at the 4-frequency pure-tone average (PTA).
The prevalence of pars flaccida (PF) retractions was higher in adults, while that of pars tensa (PT) was higher in children (p = 0.00). The degree of severity was similar between children and adults for isolated PF and PT retractions (p = 0.37 and p = 0.10, respectively). Effusion was similar in children (27.8%) and adults (33.3%). The median decibel hearing level (dB HL) (minimum-maximum) of the ABG PTA was 13.75 dB (0-57.5 dB HL) in children and 13.75 dB (0-58.7 dB) in adults (p = 0.48). There was no difference in the size of the ABG PTA between children and adults (p = 0.71), and in ABG size for isolated PF retractions (p = 0.14), PT retractions (p = 0.35), and association of PF and PT retractions (p = 0.56).
PT retractions were more prevalent in children and PF retractions in adults. There was no difference between the two groups based on the severity of the retraction. The size of the air-bone gaps was similar in children and adults.
由于有限的文献表明儿童和成人的回缩严重程度与听力损失程度之间的相关性，因此本研究旨在比较儿童和成人的鼓膜（TM）回缩位置、严重程度和气骨间隙（ABG）的差异。
这是一项在一家三级医院进行的横断面研究。评估了 2000 年 8 月至 2019 年 1 月期间患有中度或重度 TM 回缩（661 耳）的连续患者。儿科患者的平均年龄（均值±标准差）为 11.7±3.3 岁（42.4%），成年患者为 46.4±5 岁（57.6%）。所有患者均进行视频耳镜检查和纯音听阈测试。主要观察指标为回缩的位置、患病率和严重程度；4 个频率纯音平均听阈（PTA）测量的 ABG 阈值。
成人中膜松弛部（PF）回缩的患病率较高，而儿童中膜紧张部（PT）回缩的患病率较高（p=0.00）。孤立的 PF 和 PT 回缩在儿童和成人中的严重程度相似（p=0.37 和 p=0.10）。儿童（27.8%）和成人（33.3%）的积液相似。儿童 ABG PTA 的中位分贝听力水平（最小-最大）为 13.75dB（0-57.5dBHL），成人为 13.75dB（0-58.7dB）（p=0.48）。儿童和成人之间的 ABG PTA 大小无差异（p=0.71），孤立的 PF 回缩（p=0.14）、PT 回缩（p=0.35）和 PF 和 PT 回缩的相关性（p=0.56）。
PT 回缩在儿童中更为常见，PF 回缩在成人中更为常见。两组之间基于回缩的严重程度没有差异。儿童和成人的气骨间隙大小相似。
