DPOAE全频率通过的正常婴幼儿不同探测音鼓室声导抗分析

目的研究DPOAE全频率通过的正常婴幼儿不同探测音下鼓室声导抗特性,探讨其在评价婴幼儿中耳功能的应用价值。方法采用226Hz、678Hz及1kHz对101例(187耳)婴幼儿行鼓室声导抗测试,计算图形分类及1kHz鼓室声导抗图形的正常值。结果 187耳中,226Hz及1kHz鼓室声导抗出现单峰、双峰、平坦三种类型,678Hz鼓室声导抗出现单峰、双峰、平坦、碟形及三峰五种类型。1kHz鼓室声导抗图形以单峰型为主(94.65%,177/187),峰声导纳值正常范围0.33～1.01mmho,峰压力正常范围-86～+53dapa,压力范围法梯度正常范围95～188dapa,比值法梯度正常范围0.21～0.47。结论与678Hz鼓室声导抗相比,1kHz鼓室声导抗图形的稳定性更好,其单峰型图形更适用于作为6个月以内婴幼儿正常中耳功能的评判标准。     

婴幼儿宽频声导抗测试

婴幼儿外中耳解剖和功能上的特殊性,使得传统的单频声导抗测试评估婴幼儿中耳功能有一定的局限性。宽频声导抗测试可以在宽频(0.2~8 kHz)范围内评估声能的接收与传递,与传统单频声导抗相比,不需要对外耳道加压,测试时间短,可以动态评估新生儿及婴幼儿外周听觉发育特性及中耳功能。应用宽频声导抗测试可以提高婴幼儿听力筛查结果和中耳功能评估的准确性。     

多频鼓室声导抗测试在婴幼儿中耳功能诊断中的应用

目的探讨不同频率探测音声导抗测试法及多频率扫描声导抗测试法对婴幼儿中耳功能的评价效率。方法 122例听力正常婴幼儿和141例听力异常婴幼儿,应用GSI Tympstar中耳分析仪,分别以226、678、1000Hz探测音及多频率扫描声导抗测试法检测中耳功能,比较分析其测试效果。结果比较听力正常组和异常组检测结果,各月龄组的678、1000Hz探测音鼓室导纳图图形特点均有统计学意义(P0.05),但226Hz探测音鼓室导纳图在6月龄婴儿的差异无统计学意义(P0.05);组间的共振频率差异在6月龄婴儿虽无统计学意义(P0.05),在6月龄婴儿则有统计学意义(P0.05)。结论 3种频率探测音声导抗测试法对6月龄婴幼儿中耳功能诊断均较敏感,而678、1000Hz探测音对于6月龄婴儿中耳功能的诊断较为准确。随月龄增长,婴幼儿中耳共振频率逐渐升高,有助于评价6月龄婴幼儿的中耳功能。     

中耳生理学与声导抗测试

中耳生理学与声导抗测试胡岢在近代耳科临床上，声导抗测试已列为常规检查项目，鼓室压曲线的类型及坡度、静态声顺值、中耳肌声反射及其衰减时间、用声反射预估听敏度等，从这些指标不仅可以了解中耳的传声结构的功能状态，而且有助于鉴别耳聋的性质与部位，了解低位脑于...     

宽频声导抗应用于评估0-24月龄婴幼儿中耳功能检查的临床研究

目的 建立正常0-2周岁中国婴幼儿宽频声导抗(wideband tympanometry,WBT)吸收率的参考值范围.对比正常耳和分泌性中耳炎患儿宽频声导抗的鼓室图结果以及宽频能量吸收率(wideband absorbance,WBA)的差异,探讨宽频声导抗对婴幼儿中耳功能诊断的意义.方法 入选者中耳功能正常155例(...     

声导抗测试在婴儿中的应用

目的评价不同频率探测音声导抗测试及500、1000Hz镫骨肌反射测试在诊断婴儿中耳功能中的作用。方法使用GSITympstar中耳分析仪,对128例听力正常婴儿(256耳)和104例听力异常婴儿(166耳)进行226、678、1000Hz探测音声导抗测试及500、1000Hz镫骨肌反射测试,并进行比较。结果226Hz探测音鼓室导抗图表现为单峰型、双峰型、无峰型图形,<6月龄婴儿的226Hz探测音鼓室导抗图的图形特点在听力正常组和异常组间的差异无统计学意义;各月龄组的678、1000Hz探测音鼓室导抗图的图形特点在听力正常组和异常组间的差异具有统计学意义(P<0.05)。500Hz镫骨肌反射引出率与1000Hz镫骨肌反射引出率在同年龄组无明显差异(P>0.05),而在听力正常和异常组之间均具有明显差异(P<0.05)。结论678、1000Hz探测音声导抗测试是诊断小于6月龄婴儿中耳功能较准确的检查方法,3种频率探测音声导抗测试对于诊断6月龄～1岁婴儿均较敏感。500和1000Hz镫骨肌反射引出率在同月龄婴儿无明显差异,且随着年龄增长镫骨肌反射引出率逐渐增加。     

宽频声导抗研究及应用进展

宽频声导抗测试技术是一个新兴的中耳测试方法,尚处在实验研究阶段。目前的研究已经明确表明宽频声导抗的吸收率曲线在不同中耳疾患有不同于正常人群曲线的特点,且同种病变有近似的曲线趋势图。相较于传统的单频率声导抗,宽频声导抗在中耳积液的诊断上有更高的敏感度,而在鼓膜穿孔、鼓室硬化及听骨链疾患上的研究均提示有特异的吸收率曲线趋势,但尚无明确的曲线界定标准,其有效性及实用性目前尚缺乏广泛的认可度。     

多频率扫描声导抗测试对中耳病变的诊断价值

目的　进一步了解多频率扫描声导抗测试对鼓室完整的中耳病变的诊断价值。方法　对正常耳 (2 3耳 )、听骨链固定 (2 0耳 )、听骨链中断 (18耳 )、分泌性中耳炎 (2 0耳 )进行了多频率扫描声导抗测试。结果　正常耳中耳共振频率为 10 41± 191.1Hz;听骨链固定耳中耳共振频率为 12 17.5± 199.5Hz ,较正常耳高 (P <0 .0 1) ;听骨链中断耳中耳共振频率为 6 2 2 .2± 15 3.6Hz,较正常耳及听骨链固定耳均低 (P <0 .0 1) ;分泌性中耳炎中耳共振频率为 42 7.5± 139.1Hz ,较前三者均低 (P <0 .0 1)。结论　多频率扫描带导抗测试对鼓膜完整的中耳病变的鉴别诊断有一定的参考价值     

Daily tympanometry as a functional measure of middle ear status and Eustachian tube function

Objective

Tympanometry is a relatively simple method to assess middle ear (ME) status and pressure. Daily, serial tympanometric measurements may contain information on the constitutional efficiency of Eustachian tube function (ETF). A study was conducted to determine family compliance with an effort-intensive protocol that requires daily tympanometry done on each child, daily symptom recording by a parent and weekly visits with study personnel and to abstract measures that summarize the data as they relate to ETF.

Methods

Longitudinal 6-month, daily follow-up on 249 children from 123 families by parent-recorded bilateral tympanometry and cold-like illnesses.

Results

Study attrition was minimal with 90% of the enrolled families completing 90% of the study period. Parental compliance with daily tympanometry was less. Overall, 67% of the families were 80% compliant and 51% were 90% compliant. Two measures (aMEP, average middle ear pressure; vMEP, standard deviation of MEP) were evaluated for summaries of the longitudinal tympanometric results. These measures were not bilaterally independent or mutually independent and were affected by cold-burden and age. The best summary measure of constitutional ET efficiency may be a dimensional map of vMEP on aMEP with subsequent subdivision of the dimensional space into zones with functional interpretations.

Conclusion

Long-term studies that require daily parental recording of tympanometry and the presence/absence of cold-like illness are feasible. It is expected that compliance with the required procedures can be increased substantially by pre-selection of candidate families. Preliminary data analyses suggest that the longitudinal tympanometric data contains important information on constitutional ETF.     

低频和高频探测音鼓室声导抗测试在婴儿中耳功能诊断中的作用

目的评价低频和高频探测音鼓室声导抗测试在诊断婴儿中耳功能异常中的作用。方法使用GSI Tympstar中耳分析仪，对年龄5—25周的听性脑干反应（auditory brainstem response，ABR）检查正常婴儿15例（30耳）和Ⅰ波潜伏期延长提示可能存在中耳功能异常婴儿17例（20耳），进行226、678、1000Hz探测音鼓室声导抗测试的比较。结果226Hz探测音鼓室声导纳图的静态声导纳值、图形、峰压和梯度在2组间的差异无统计学意义。678Hz探测音鼓室声导纳图、声纳图及声导图在2组中均可见无峰型、单峰型、双峰型、三峰型图形，其与ABR检查的一致率分别为70．0％、58．0％、64．0％，kappa值分别为0．324、0．234、0．118。1000Hz探测音鼓室声导纳图、声纳图及声导图在正常组中单峰型分别为28耳（93．3％）、25耳（83．3％）、26耳（86．7％），在异常组中无峰型分别为15耳（75％）、17耳（85％）、13耳（65％），其与ABR的一致率分别为90．0％、92．0％、86．0％，kappa值分别为0．783、0．831、0．690。结论1000Hz探测音鼓室声导抗测试是诊断小于25周婴儿中耳功能的较准确的检查方法，226、678Hz探测音鼓室声导抗测试则不能提供这些婴儿中耳功能的准确的信息。     

Validity of tympanometry in the diagnosis of middle ear effusion

A group of 266 children (515 ears), ranging in age from 5 months to 11 years, was studied. These children were candidates for the insertion of ventilation tubes, or adenoidectomy and/or tonsillectomy with myringotomy. Before surgery, tympanometry was performed. The surgical and tympanometric findings were compared afterwards. Two different tympanometers were used (GSI-27A and TYMP-85TT). This study showed a comparable validity of these two tympanometers. The sensitivity and specificity of tympanometry in the age group of 5 months to 2 years did not show a significant difference from that in the age group of 2–12 years. Otoscopy has limited value for the diagnosis of middle ear effusion in this age group.     

Otoscopy and tympanometry in screening for middle ear disorders in children

In this study tympanometry and otoscopy were conducted in 893 children in Kuwait. Otoscopic examination revealed pathologic findings in 41.7%, while 30.6% had type B or C tympanograms. Based on referral criteria commonly used in tympanometry 31% of the children should be referred for further evaluation. Using the combined otoscopic and tympanometric evaluation of the ears the referral rate could be reduced to 18%.     

Pneumatic otoscopy and tympanometry in the detection of middle ear effusion

A prospective study was designed to assess the relative merits of pneumatic otoscopy and tympanometry in predicting the presence of a middle ear effusion, and to determine if both tests in conjunction provided any significant advantage. In 121 patients (222 ears) pneumatic otoscopy with a Seigles speculum and tympanometry were performed prior to myringotomy. An immobile tympanic membrane on otoscopy, or a Jerger type B curve on tympanometry were considered indicative of a middle ear effusion. There was no significant difference (P greater than 0.05) between the predictive value of pneumatic otoscopy (88%) and tympanometry (89%). When pneumatic otoscopy and tympanometry were used in conjunction, the predictive accuracy did not increase significantly. Pneumatic otoscopy and tympanometry are simple and reliable methods of predicting the presence or absence of a middle ear effusion. Their use together did not increase diagnostic accuracy.     

Monitoring middle ear pressure by tympanometry. A study of middle ear pressure variation through seven hours

The aim of this investigation was to monitor fluctuations in middle ear pressure, to study tympanometric signs of Eustachian tube functioning and to assess the validity of the tympanometric readings. In 20 patients with a low initial middle ear pressure (-150 daPa or lower) and 5 normals, impedance tympanometry was performed every 3 min through 7 h. Median pressure for the patients was -150 daPa (range 100 to -400 daPa) and for the normals 0 daPa (range 50 to -50 daPa). A remarkable pressure increase was seen after changing the body position to the supine. The patients were arranged into three groups according to the lowest middle ear pressure registered. Median pressures for the groups were running at a rather constant level. However, the individual pressure fluctuations in many patients were so great that a single tympanometric reading has to be considered unreliable when selecting patients for insertion of ventilation tubes. Thirteen patients never equalized their negative middle ear pressure, indicating that their Eustachian tube did not open during the test period. In spite of this the pressure did not decrease to lower values, indicating that maintaining a relative constant middle ear pressure is independent of opening of the Eustachian tube.