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[咽鼓管功能测试中声导抗与耳咽管异常开放症的相关性]

[Correlation between acoustic immittance and ETS in eustachian tube function test].

作者信息

Yang Yali, Wang Shijie, Han Shuguang, Gong Shusheng, Liu Jiao, Lu Jieqiong, Zhang Shuang, Wang Wei

机构信息

Department of Otolaryngology Head and Neck Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing,100050,China.

Department of Otolaryngology,No. 731 Hospital of China Aerospace Science and Industry Corp,Beijing.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Aug;36(8):587-591. doi: 10.13201/j.issn.2096-7993.2022.08.004.

Abstract

To investigate the correlation between acoustic immittance and eustachian tube score(ETS) in eustachian tube function test. 124 ears eustachian tube function with tympanic tension perforation of 107 patients with chronic suppurative otitis media were measured by acoustic immittance positive pressure balance method and ETS. According to the positive pressure balance test results of acoustic immittance, the ear eustachian tube open pressure between 100 and 200 daPa is assigned 2, the ear with open pressure between 200 and 300 daPa is assigned 3, the ear with open pressure betwween 300 and 400 daPa is assigned 4, the ear open pressure is greater than 400 daPa but eustachian tube open after swallowing is assigned 5, and the ear which eustachian tube open pressure is greater than 400 daPa and cannot open after swallowing is assigned 6. Then compare the results. In the acoustic immittance test, there was no ears whose eustachian tube opening pressure less than 100 daPa, 10 ears(8.1%) open pressure between 100 and 200 daPa, 16 ears(12.9%) open pressure between 200 and 300 daPa, 46 ears(37.1%) open pressure between 300 and 400 daPa, 19 ears(15.3%) whose eustachian tube don't open pressure at 400 daPa but open after swallowing, and the cumulative percentage of the above was 73.4%. There were 33 ears(26.6%) whose eustachian tubes not opening after receiving maximum pressure(400 daPa) and repeated swallowing. The score of acoustic immittance eustachian tube function test was significantly correlated with the scores of ETS, eustachian tube manometry(TMM) and subjective part of ETS(<0.05). The result of acoustic immittance was moderately negatively correlated with ETS(=-0.439) and TMM(=-0.425), and weakly negatively correlated with subjective part of ETS(=-0.249). The scores of 2-5 points (the affected ears with open eustachian tube in all acoustic impedance test methods) were defined as the normal group, and the scores of 6 point were defined as the abnormal group. The results of acoustic immittance between the normal group and the abnormal group showed that there were significant differences with the subjective scores of ETS, TMM and ETS. The consistency compared the results of acoustic immittance eustachian tube test with the results of ETS was poor(kappa value was negative), and the difference was statistically significant. The open pressure of acoustic immittance positive pressure balance method is a good predictor of the subjective scores of ETS, TMM and ETS. The smaller the open pressure is, the better the subjective scores of ETS, TMM and ETS may be. This two methods results are inconsistent and cannot be replaced. More consideration should be given to the middle ear. The open pressure, equilibrium pressure and the difference between them need to be paid attention to at the same time.

摘要

探讨咽鼓管功能测试中声导抗与咽鼓管评分(ETS)之间的相关性。采用声导抗正压平衡法和ETS对107例慢性化脓性中耳炎鼓膜紧张部穿孔患者的124耳咽鼓管功能进行检测。根据声导抗正压平衡测试结果,咽鼓管开放压在100~200 daPa之间的耳赋值为2,开放压在200~300 daPa之间的耳赋值为3,开放压在300~400 daPa之间的耳赋值为4,开放压大于400 daPa但吞咽后咽鼓管开放的耳赋值为5,开放压大于400 daPa且吞咽后不能开放的耳赋值为6。然后比较结果。在声导抗测试中,无咽鼓管开放压小于100 daPa的耳,开放压在100~200 daPa之间的耳有10耳(8.1%),开放压在200~300 daPa之间的耳有16耳(12.9%),开放压在300~400 daPa之间的耳有46耳(37.1%),开放压未达400 daPa但吞咽后开放的耳有19耳(15.3%),以上累计百分比为73.4%。有33耳(26.6%)在接受最大压力(400 daPa)并反复吞咽后咽鼓管仍未开放。声导抗咽鼓管功能测试评分与ETS评分、咽鼓管测压(TMM)及ETS主观部分评分显著相关(<0.05)。声导抗结果与ETS呈中度负相关(=-0.439),与TMM呈中度负相关(=-0.425),与ETS主观部分呈弱负相关(=-0.249)。将2~5分(所有声阻抗测试方法中咽鼓管开放的患耳)定义为正常组,6分定义为异常组。正常组与异常组声导抗结果显示,与ETS主观评分、TMM及ETS主观部分评分有显著差异。声导抗咽鼓管测试结果与ETS结果比较一致性较差(kappa值为负),差异有统计学意义。声导抗正压平衡法的开放压是ETS主观评分、TMM及ETS主观部分评分的良好预测指标。开放压越小,ETS主观评分、TMM及ETS主观部分评分可能越好。这两种方法结果不一致且不能相互替代。应更多考虑中耳情况。同时需关注开放压、平衡压及其差值。

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[Correlation between acoustic immittance and ETS in eustachian tube function test].[咽鼓管功能测试中声导抗与耳咽管异常开放症的相关性]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Aug;36(8):587-591. doi: 10.13201/j.issn.2096-7993.2022.08.004.
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[Progress in the tests of eustachian tube function].[咽鼓管功能测试的进展]
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Clin Otolaryngol. 2015 Aug;40(4):300-11. doi: 10.1111/coa.12428.
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Eustachian tube function in adults without middle ear disease.无中耳疾病成人的咽鼓管功能
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