Sheng H B, Zhou Q, Li H F, Ren Y, Han K, Huang M P, Chen Y, Li B, Li Y, Huang Z W
Department of Otorhinolaryngology Head and Neck Surgery, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200092, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jun 7;56(6):579-585. doi: 10.3760/cma.j.cn115330-20200828-00702.
To study the characteristics of wideband tympanometry(WBT) and its application value in the diagnosis of otitis media with effusion(OME) in young children. We compared wideband acoustic energy absorbance(EA) under peak pressure in young children with OME(190 ears) and healthy control subjects(121 ears) from Ninth People's Hospital of Shanghai Jiaotong University School of Medicine between January 2018 and June 2020. Both groups were divided into three groups, 1-6 months, 7-36 months and 37-72 months. SPSS 20.0 statistical software was used to analyze and compare the EA parameters between OME children of different months and the control group. Receiver operating characteristic (ROC)curve was used to analyze the diagnostic value of WBT in young children with OME. There were significant differences in EA among three OME groups from 500 Hz to 2 000 Hz(<0.05).Compared with the control groups, EA of 1-6 m OME group decreased significantly below 4 000 Hz(<0.05), EA of 7-36 m OME group decreased significantly at 545-1 600 Hz(<0.05), EA of 37-72 m OME group decreased significantly above 545 Hz(<0.05).ROC curve indicated that EA at 1 000 Hz had the greatest diagnostic value (AUC was 0.890), followed by 1 500 Hz and the range of 500-2 000 Hz (AUC was 0.883 and 0.881, respectively).EA at 1 000 Hz with a cutoff value of 0.55 had the best diagnostic sensitivity of 90.8%, which was higher than conventional tympanometry (85.8%). The maximum AUC (0.932) could be obtained by combining EA, peak pressure and admittance amplitude of 226 Hz tympanometry as predictors. EA is significantly decreased in young children with OME. Compared with the conventional single frequency tympanometry, WBT is more accurate in the diagnosis of OME in young children, and the prediction accuracy would be better if combined with 226 Hz tympanometry.
研究宽频鼓室导抗图(WBT)的特征及其在小儿分泌性中耳炎(OME)诊断中的应用价值。我们比较了2018年1月至2020年6月上海交通大学医学院附属第九人民医院OME患儿(190耳)和健康对照者(121耳)在峰值压力下的宽频声能吸收率(EA)。两组均分为1 - 6个月、7 - 36个月和37 - 72个月三组。采用SPSS 20.0统计软件分析比较不同月龄OME患儿与对照组之间的EA参数。采用受试者操作特征(ROC)曲线分析WBT对小儿OME的诊断价值。三组OME患儿在500 Hz至2000 Hz的EA存在显著差异(<0.05)。与对照组相比,1 - 6个月OME组在4000 Hz以下EA显著降低(<0.05),7 - 36个月OME组在545 - 1600 Hz EA显著降低(<0.05),37 - 72个月OME组在545 Hz以上EA显著降低(<0.05)。ROC曲线表明,1000 Hz处的EA诊断价值最大(AUC为0.890),其次是1500 Hz以及500 - 2000 Hz范围(AUC分别为0.883和0.881)。1000 Hz处EA截断值为0.55时诊断敏感性最佳,为90.8%,高于传统鼓室导抗图(85.8%)。将EA、峰值压力和226 Hz鼓室导抗图的声导纳幅值作为预测指标联合应用可获得最大AUC(0.932)。OME患儿的EA显著降低。与传统单频鼓室导抗图相比,WBT对小儿OME的诊断更准确,联合226 Hz鼓室导抗图时预测准确性更佳。