Szucs E, Diependaele R, Clement P A
Department of Otorhinolaryngology, Brussels Free University, VUB, Belgium.
Acta Otorhinolaryngol Belg. 1995;49(3):287-92.
Tympanometry has become a widely accepted diagnostic tool for the diagnosis of otitis media with effusion (OME). The present study was conducted to assess the accuracy of the technique by calculating its sensitivity and specificity. Forty children with chronic OME and recurrent otitis media were studied. Immediate preoperative tympanograms were compared with operative findings of tympanocentesis, and sensitivity and specificity data were calculated. Approximately one third of the B type tympanograms (effusion) changed to A (effusion free) or C type (possible effusion) during the waiting period for the operation, showing resorption of fluid from the middle ear cavity. Sensitivity score was 95% bearing out the C type tympanograms. When C type tympanograms were included into the calculation, sensitivity dropped to 73%, showing liquid frequently present in cases of C type tympanograms. Tympanometry scored as more reliable in the presence of adenoid hypertrophy, when sensitivity was 83% and specificity was 90%. The absence of adenoid hypertrophy led to a drop of sensitivity to 58% and to a drop of specificity to 71%. These results may indicate that inhalant induction of anaesthesia has less effect on the middle ear in the presence of adenoidal hypertrophy and concomitant eustachian tubal dysfunction. Tympanometry proved to be a reliable diagnostic tool for the diagnosis of otitis media with effusion. Long preoperative waiting periods and the absence of adenoid hypertrophy could be responsible for the differences between preoperative tympanograms and the middle ear status observed at tympanocentesis.
鼓室导抗图已成为诊断中耳积液（OME）广泛接受的诊断工具。本研究旨在通过计算其敏感性和特异性来评估该技术的准确性。对40例患有慢性OME和复发性中耳炎的儿童进行了研究。将术前即刻鼓室导抗图与鼓膜穿刺术的手术结果进行比较，并计算敏感性和特异性数据。大约三分之一的B型鼓室导抗图（积液）在手术等待期间变为A（无积液）型或C型（可能有积液），表明中耳腔内的液体吸收。C型鼓室导抗图的敏感性评分为95%。当将C型鼓室导抗图纳入计算时，敏感性降至73%，表明C型鼓室导抗图的病例中经常存在液体。在腺样体肥大的情况下，鼓室导抗图评分更可靠，此时敏感性为83%，特异性为90%。腺样体肥大的缺失导致敏感性降至58%，特异性降至71%。这些结果可能表明，在腺样体肥大和伴有咽鼓管功能障碍的情况下，吸入诱导麻醉对中耳的影响较小。鼓室导抗图被证明是诊断中耳积液的可靠诊断工具。术前等待时间长和腺样体肥大的缺失可能是术前鼓室导抗图与鼓膜穿刺术时观察到的中耳状态之间差异的原因。
