听力学检查对儿童急性非化脓性中耳炎诊断的意义

目的：探讨声导抗、畸变产物耳声发射（DPOAE）和听性脑干反应（ABR）测试在儿童急性非化脓性中耳炎诊断中的作用。方法回顾性分析182例急性非化脓性中耳炎患儿的临床资料，比较218耳有症状耳与146耳无症状耳的声导抗、DPOAE及ABR结果。结果有症状耳鼓室导抗图、DPOAE、ABR 异常的检出率分别为64．7％、72．0％、57．8％，明显高于无症状耳的41．8％、39．7％、35．6％，差异均有统计学意义（均为P＜0．05）；有症状耳至少一项结果异常者高达196耳（89．9％），高于无症状耳（90耳，61．6％），差异有统计学意义（P＜0．05）；有症状耳鼓室导抗图为B型或C型者占60．6％，无症状耳鼓室导抗图为B型或C型者占41．8％。结论儿童急性非化脓性中耳炎的诊断不仅根据症状和体征，还应结合声导抗、DPOAE和ABR等检查综合考虑，尤其是对于无症状耳可减少误诊和漏诊。

Audiological Detection in the Diagnosis of Children with Acute Non-Suppurative Otitis Media (AN-SOM)

Objective To study the potential roles of acoustic immittance,distortion product otoacoustic e-mission (DPOAE),and the brainstem response audiometry (ABR)in the diagnosis of children with acute non-sup-purative otitis media (AN-SOM).Methods A retrospective analysis was administered to 182 cases with AN-SOM at the otolaryngology department between March 2014 and March 2015.We compared the results of the acous-tic immitance of 218 symptomatic ears and 146 asymptomatic ears,and also the proportion of DPOAE abnormity and ABR abnormity.We analyzed the specialty of symptomatic ears and asymptomatic ears in 3 terms of audiology test results.Results The proportions of abnormal tympanograms,DPOAE,ABR for symptomatic ear were 64.7%, 72.0%,and 57.8%,which were significantly higher than those of in 41.8%,39.7%,and 35.6% in asymptomatic ear.The difference were statistically significant(P<0.05).A further analysis of audiologic results showed that at least one abnormal result was as high as 196 ears (89.9%)in the asymptomatic ear,90 ears (61.6%)showed no symptoms.The differences were statistically significant(P<0.05).The results of audiology tests showed that tym-panograms in symptomatic ears showed diversity,that were 60.6% for type B or C,35.3% for type A,4.1% for the As.Conclusion The early detections by using acoustic immitance,DPOAE and ABR are very important to the diagnosis of children with acute non-suppurative otitis media.It can improve the sensitivity,and reduce the misdi-agnosis.