多频鼓室导抗测试在梅尼埃病患者中的诊断价值：一项前瞻性分析。

The Diagnostic Value of Multifrequency Tympanometry in Patients with Ménière's Disease: A Prospective Analysis.

机构信息

Otorhinolaryngology and Head and Neck Surgery Department, University Medical Centre Utrecht, Utrecht, The Netherlands,

Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Audiol Neurootol. 2023;28(4):272-279. doi: 10.1159/000528852. Epub 2023 Feb 15.

DOI:10.1159/000528852

PMID:36791680

Abstract

INTRODUCTION

Diagnosing Ménière's disease (MD) by its characteristics such as episodes of vertigo, fluctuating hearing loss, and tinnitus with aural fullness remains challenging. Available tests evaluating the presence of endolymphatic hydrops (EH) are often expensive or time assuming. An in-office quick and simple non-invasive diagnostic test is multifrequency tympanometry (MFT). It can measure conductance at 2 kHz probe tones, which was demonstrated to reflect variations in cochlear pressure. Previous studies investigating MFT as a diagnostic test for MD showed conflicting outcomes possibly biased by their retrospective design.

METHODS

We prospectively collected MFT results (Y width) in patients with dizziness and compared MFT test results in affected (group 1) and unaffected (group 2) ears of 37 MD subjects and in control ears of 33 non-MD subjects (group 3).

RESULTS

The mean value of the Y width in affected ears was 315.6 ± 70.2 daPa compared to 292.3 ± 98.6 daPa in unaffected ears in MD subjects and 259.4. ± 60.6 daPa in the non-MD group. A positive test result (i.e., a Y width of 235 daPa or more) was found in 35 ears in the MD group, 21 times involving the affected ear and 14 times involving the unaffected ear, compared to 16 in the non-MD group. No significant differences between the three groups could be demonstrated (p > 0.05). We found a sensitivity of 58.3% and specificity of 66.3% for detecting EH in an affected ear in MD subjects.

CONCLUSION

There is a trend towards increased conductance tympanometry in affected ears. However, we noticed a high false positive rate of MFT and do not support standardized use of MFT as an additional diagnostic tool for detecting EH in MD patients. A negative test result on the contrary is unlikely related to EH.

摘要

简介

通过眩晕发作、波动性听力损失和耳闷胀感伴耳鸣等特征来诊断梅尼埃病（MD）仍然具有挑战性。评估内淋巴积水（EH）存在的可用测试通常既昂贵又耗时。一种在办公室进行的快速简便的非侵入性诊断测试是多频鼓室压测量（MFT）。它可以测量 2 kHz 探测音的导纳，这被证明可以反映耳蜗压力的变化。先前研究表明，MFT 作为 MD 的诊断测试具有一定的价值，但这些研究结果存在冲突，这可能是由于其回顾性设计而存在偏倚。

方法

我们前瞻性地收集了眩晕患者的 MFT 结果（Y 宽度），并比较了 37 例 MD 患者受影响（第 1 组）和未受影响（第 2 组）耳以及 33 例非 MD 患者（第 3 组）对照耳的 MFT 测试结果。

结果

MD 患者受影响耳的 Y 宽度平均值为 315.6 ± 70.2 daPa，未受影响耳为 292.3 ± 98.6 daPa，非 MD 组为 259.4 ± 60.6 daPa。在 MD 组中，35 只耳的测试结果为阳性（即 Y 宽度≥235 daPa），其中 21 次涉及受影响耳，14 次涉及未受影响耳，而非 MD 组为 16 次。三组间无显著差异（p＞0.05）。我们发现 MD 患者中，检测受影响耳 EH 的敏感性为 58.3%，特异性为 66.3%。