Marchant C D, McMillan P M, Shurin P A, Johnson C E, Turczyk V A, Feinstein J C, Panek D M
J Pediatr. 1986 Oct;109(4):590-5. doi: 10.1016/s0022-3476(86)80218-9.
Otitis media in early infancy carries a high risk of recurrent otitis media and prolonged middle ear effusion. To fulfill the need for objective diagnostic methods in this age group, we investigated susceptance tympanograms and ipsilateral acoustic reflex thresholds in infants younger than 5 months of age. Tympanometry and acoustic reflex thresholds were performed with an otoadmittance meter using a 660 Hz probe tone. Tympanograms were interpreted using quantitative measures. These findings were compared with independent otoscopic diagnoses in 67 ears with middle ear effusion and 69 ears that were effusion free. Diagnoses were confirmed by tympanocentesis when clinically indicated. There was excellent agreement among otoscopy, peak tympanogram susceptance, and ipsilateral acoustic reflex thresholds (kappa 0.82 to 0.86, agreement 91% to 93%). We conclude that susceptance tympanograms and ipsilateral acoustic reflex thresholds are accurate diagnostic tests for otitis media in infants younger than 5 months of age.
婴儿早期的中耳炎有较高的复发性中耳炎和持续性中耳积液风险。为满足该年龄组客观诊断方法的需求，我们对5个月以下婴儿的声导纳鼓室图和同侧听觉反射阈值进行了研究。使用耳声导抗仪，以660Hz探测音进行鼓室图测量和听觉反射阈值检测。鼓室图采用定量测量方法进行解读。将这些结果与67例有中耳积液的耳朵和69例无积液的耳朵的独立耳镜诊断结果进行比较。临床有指征时，通过鼓膜穿刺术确诊。耳镜检查、鼓室图声导纳峰值和同侧听觉反射阈值之间有极佳的一致性（kappa值为0.82至0.86，一致性为91%至93%）。我们得出结论，声导纳鼓室图和同侧听觉反射阈值是5个月以下婴儿中耳炎的准确诊断测试。
