Chen Chin-Kuo, Wan Yung-Liang, Hsieh Li-Chun, Tsui Po-Hsiang
Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan.
School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan.
Life (Basel). 2022 Apr 18;12(4):599. doi: 10.3390/life12040599.
Medical history taking, otoscopy, tympanometry, and audiometry are clinical methods to diagnose middle ear effusion (MEE); however, these procedures are experience-dependent and result in misdiagnosis under unfavorable conditions of the external auditory canal in non-cooperative young children. This study aimed to explore the use of transmastoid ultrasound combined with the Nakagami parameter analysis to detect MEE in children aged 3−5 years and to compare the proposed method with clinical evaluation methods. A total of forty subjects were enrolled; for each subject, a single-element ultrasound transducer of 2.25 MHz was used to measure backscattered signals returned from the mastoid for estimating the Nakagami parameter, which is a measure of the echo amplitude distribution. Tympanogram and hearing loss were also measured for comparisons. The results showed that the Nakagami parameter in the patients with MEE was significantly larger than that of the normal group (p < 0.05). The area under the receiver operating characteristic curve (AUROC) for using the Nakagami parameter to detect MEE was 0.90, and the sensitivity, specificity, and accuracy were 82.5%, 97.5%, and 79.6%, respectively. The Nakagami parameter for tympanogram types B/C was higher than that for tympanogram type A (p < 0.05); it was also higher in the subjects with hearing loss (p < 0.05). Quantitative transmastoid ultrasound based on the Nakagami parameter analysis has the potential to detect MEE and evaluate hearing loss.
病史采集、耳镜检查、鼓室导抗图测试和听力测定是诊断中耳积液（MEE）的临床方法；然而，这些程序依赖经验，在不合作幼儿外耳道条件不利的情况下会导致误诊。本研究旨在探讨经乳突超声联合 Nakagami 参数分析在检测 3 - 5 岁儿童中耳积液中的应用，并将该方法与临床评估方法进行比较。共招募了 40 名受试者；对于每名受试者，使用 2.25 MHz 的单元素超声换能器测量从乳突返回的背向散射信号，以估计 Nakagami 参数，该参数是回声幅度分布的一种度量。还测量了鼓室导抗图和听力损失以作比较。结果显示，中耳积液患者的 Nakagami 参数显著大于正常组（p < 0.05）。使用 Nakagami 参数检测中耳积液的受试者工作特征曲线下面积（AUROC）为 0.90，灵敏度、特异度和准确度分别为 82.5%、97.5%和 79.6%。鼓室导抗图 B/C 型的 Nakagami 参数高于 A 型（p < 0.05）；听力损失受试者的该参数也更高（p < 0.05）。基于 Nakagami 参数分析的定量经乳突超声有潜力检测中耳积液并评估听力损失。
