儿童分泌性中耳炎鼓膜置管前后听性脑干反应的特征

目的：评价儿童分泌性中耳炎鼓膜置管前后听性脑干反应（ABR）的特征及变化。方法：回顾性分析行鼓膜置管的37例分泌性中耳炎患儿（研究组）手术前后的ABR资料，并与30例健康儿童（对照组）的ABR资料相对比；将研究组再按波形分化程度分为波形分化不良组和波形分化较好组，对两组的病程及波Ⅴ反应阈等进行比较。结果：①儿童分泌性中耳炎可以影响ABR的波形分化和各波出现率，手术后有改善；术前波形分化不良组的波Ⅴ反应阈及病程与波形分化较好组相比，差异有统计学意义（P〈0．01或P〈0．05）。②Ⅰ、Ⅲ、Ⅴ波潜伏期术后较术前明显缩短且差异有统计学意义（P〈0．05），但手术前后波间期的改变无统计学意义。③与对照组相比，手术前后均存在部分波潜伏期及波间期的异常，且有统计学意义。结论：儿童分泌性中耳炎的ABR表现为：波形分化及出现率的改变、波间期及波潜伏期的改变、波Ⅴ反应阈的改变，鼓膜置管术可以改善这些变化，但仍未达到对照组水平。

Auditory brainstem response in children before and after myringotomy with grommet insertion

OBJECTIVE: To explore the characteristics of auditory brainstem response (ABR) in children with otitis media with effusion (OME) before and after myringotomy with grommet insertion. METHOD: ABR were recorded in 37 cases (74 ears) before receiving myringotomy with grommet insertion for OME (treating group). For comparison, 30 age-matched healthy children were also tested with ABR (control group). To evaluate the immediate effect of tube placement, 74 ears were tested immediately the day after tube insertion. The characteristics of ABR before and after operation were compared with the control group. Thirty-seven cases were further divided into two groups: the group with poor wave differentiation and the group with better wave differentiation. The threshold of wave V, course of disease were compared between the two groups. RESULT: (1) Wave differentiation and eliciting rate were influenced by OME and were improved after operation. The group with poor wave differentiation had elevated threshold of wave V and had longer duration of the disease. (2) The prolonged peak latencies (waves I, III and V) were decreased significantly (P < 0.05) in the day after tube placement. However, no statistically significant change was found in the transmission time between waves. (3) When comparing to the control group, the abnormal peak latencies and transmission time between waves before and after myringotomy with grommet insertion were observed. CONCLUSION: The abnormal ABR can be observed in children with OME and improved after myringotomy with grommet insertion, but it can't reach the normal level.