Gates G A, Avery C, Cooper J C, Hearne E M, Holt G R
Ann Otol Rhinol Laryngol. 1986 Jan-Feb;95(1 Pt 1):46-50. doi: 10.1177/000348948609500110.
The presence of middle ear effusion may be inferred from a tympanogram by the configuration of the pressure compliance curve. Not infrequently, however, effusion is absent at the time of surgery when strongly indicated by preoperative tympanometry. We evaluated this discrepancy by contrasting preoperative tympanograms with the findings at surgery in 462 children, aged 4 to 8 years, with clinical evidence of persistent effusion in 909 ears. Based on these results we can classify tympanograms as to high risk for effusion, intermediate, and low risk. The proportion of ears with effusion was 83%, 47%, and 34%, respectively. The proportion of ears with fluid in the high risk tympanogram group did not change appreciably over a 1- to 8-week period, ie, no trend toward spontaneous resolution occurred. The high incidence of effusion at surgery in our low risk group is far higher than expected and is presumably due to reinfection of these ears during the time between examination and operation.
中耳积液的存在可通过鼓室导抗图中压力顺应性曲线的形态来推断。然而，在术前鼓室导纳测量强烈提示有积液的情况下，手术时积液却常常并不存在。我们通过对比462名4至8岁儿童术前鼓室导抗图与手术结果，评估了这一差异，这些儿童909只耳朵有持续性积液的临床证据。基于这些结果，我们可将鼓室导抗图分为积液高风险、中等风险和低风险。有积液的耳朵比例分别为83%、47%和34%。高风险鼓室导抗图组中有积液的耳朵比例在1至8周内没有明显变化，即没有自发消退的趋势。我们低风险组手术时积液的高发生率远高于预期，推测是由于在检查和手术期间这些耳朵再次感染所致。
