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[中耳胆脂瘤与慢性化脓性中耳炎的宽带声导抗特征及鉴别诊断]

[Characteristics and differential diagnosis of middle ear cholesteatoma and chronic suppurative otitis media with wideband acoustic immittance].

作者信息

Xu Jifeng, Jiang Wen, Liu Jie, Wang Hao, Zhao Zeqi, Liu Wen, Li Wei

机构信息

First College of Clinical Medicine,Xuzhou Medical University,Xuzhou,221000,China.

Department of Otolaryngology,Affiliated Hospital of Xuzhou Medical University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 May;36(5):376-381. doi: 10.13201/j.issn.2096-7993.2022.05.011.

Abstract

Through analysis of the sound energy absorbance of wideband acoustic immittance to provide a basis for differential diagnosis of adult acquired secondary cholesteatoma of the middle ear and patients with chronic suppurative otitis media(CSOM). 38 cases of cholesteatoma and 40 cases of CSOM admitted to the Department of Otolaryngology, Affiliated Hospital of Xuzhou Medical University from September 2020 to December 2021 were selected as the research group, and 30 cases (60 ears) of normal adults were selected as the control group. A total of 16 frequency points were selected, and the energy absorbance of wideband acoustic immittance was taken as the research parameter. The characteristics of energy absorbance under ambient pressure among the three are compared. Then the ROC in the cholesteatoma group was drawn, and by calculating the AUC, the Cut-off values and the corresponding sensitivity and specificity were found. The energy absorbance in CSOM group at 1100-5700 Hz and the cholesteatoma group at 560-5700 Hz was lower than that in the control group, and the difference in some frequency bands was statistically significant. The energy absorbance in the cholesteatoma group at 226-7100 Hz was lower than that in the CSOM group, and the difference between the two groups in many frequency points was statistically significant. The ROC in the research group was drawn and it was found that the AUC in the 560, 710, 890, and 4500 bands was > 0.5, and in the other bands was > 0.7(<0.05). The AUC in the 2800 Hz was the largest (0.78), the Cut-off value was 0.31, the corresponding sensitivity was 78.38%, specificity was 73.33%. Wideband acoustic immittance can be used as an auxiliary method for the differential diagnosis of adult-acquired secondary cholesteatoma of the middle ear and chronic suppurative otitis media in adults.

摘要

通过分析宽频声导抗的声能吸收率,为成人获得性中耳继发性胆脂瘤与慢性化脓性中耳炎(CSOM)患者的鉴别诊断提供依据。选取2020年9月至2021年12月徐州医科大学附属医院耳鼻咽喉科收治的38例胆脂瘤患者和40例CSOM患者作为研究组,选取30例正常成年人(60耳)作为对照组。共选取16个频率点,将宽频声导抗的能量吸收率作为研究参数。比较三者在常压下的能量吸收率特征。然后绘制胆脂瘤组的ROC曲线,通过计算AUC,得出截断值及相应的灵敏度和特异度。CSOM组在1100 - 5700Hz、胆脂瘤组在560 - 5700Hz的能量吸收率低于对照组,部分频段差异有统计学意义。胆脂瘤组在226 - 7100Hz的能量吸收率低于CSOM组,两组在多个频率点差异有统计学意义。绘制研究组的ROC曲线,发现560、710、890和4500频段的AUC>0.5,其他频段>0.7(P<0.05)。2800Hz的AUC最大(0.78),截断值为0.31,相应的灵敏度为78.38%,特异度为73.33%。宽频声导抗可作为成人获得性中耳继发性胆脂瘤与成人慢性化脓性中耳炎鉴别诊断的辅助方法。

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本文引用的文献

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[A preliminary study on characteristics of wideband acoustic immittance in patients with Meniere's disease].[梅尼埃病患者宽带声导抗特征的初步研究]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec;35(12):1068-1072. doi: 10.13201/j.issn.2096-7993.2021.12.003.
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[The clinical value of wideband tympanometry in the diagnosis of otitis media with effusion].宽带鼓室声导抗测试在分泌性中耳炎诊断中的临床价值
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Sep;32(17):1309-1315. doi: 10.13201/j.issn.1001-1781.2018.17.005.
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[The study of wideband acoustic immittance normative data of young people].[年轻人宽带声导抗标准数据的研究]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Sep 20;31(18):1402-1407. doi: 10.13201/j.issn.1001-1781.2017.18.006.
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Normative Study of Wideband Acoustic Immittance Measures in Newborn Infants.新生儿宽带声导抗测量的规范性研究
J Speech Lang Hear Res. 2017 May 24;60(5):1417-1426. doi: 10.1044/2016_JSLHR-H-16-0237.

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