听力学及言语疾病杂志
聽力學及言語疾病雜誌
은역학급언어질병잡지
JOURNAL OF AUDIOLOGY AND SPEECH PATHOLOGY
2010年
2期
135-137
,共3页
腺样体%中耳炎%声导抗%计算机体层摄影
腺樣體%中耳炎%聲導抗%計算機體層攝影
선양체%중이염%성도항%계산궤체층섭영
Adenoid%Otitis media%Tympanometry%Computered tomography
目的 探讨腺样体肥大对儿童中耳功能的影响.方法 回顾性分析272例(544耳)腺样体肥大患儿的临床资料,患儿年龄2～12岁,平均6.3岁,分为主诉无听力下降组(A组)94例(188耳)和主诉有听力下降组(B组)178例(356耳),均于腺样体摘除术前行鼓膜镜、声导抗和中耳CT检查.结果 CT显示272例(544耳)中有鼓室积液209例(396耳)(72.79%,396/544),其中,A组37例(65耳),占34.57%(65/188),B组172例(331耳),占92.98%(331/356),以上均经手术证实鼓室有积液;两组中B型鼓室导抗图377耳,其中,经CT及手术证实鼓室有积液的共373耳(98.94%,373/377),其中A组61耳(93.85%,61/65),B组312耳(100%,312/312),B组B型鼓室图对中耳积液的阳性预测值高于A组(P＜0.01);C型鼓室导抗图73耳中,峰压值小于-200 daPa的14耳及镫骨肌反射未引出的51耳中23耳经CT及手术证实鼓室有积液,镫骨肌反射可引出的22耳鼓室均无积液.CT发现B组有2例(4耳)前庭水管扩大和1例(2耳)耳蜗畸形.结论 对于腺样体肥大儿童,B型鼓室导抗图对中耳积液的预测值高,C型鼓室导抗图峰压值负于-200 daPa不排除鼓室积液,应以CT作最终确认.
目的 探討腺樣體肥大對兒童中耳功能的影響.方法 迴顧性分析272例(544耳)腺樣體肥大患兒的臨床資料,患兒年齡2～12歲,平均6.3歲,分為主訴無聽力下降組(A組)94例(188耳)和主訴有聽力下降組(B組)178例(356耳),均于腺樣體摘除術前行鼓膜鏡、聲導抗和中耳CT檢查.結果 CT顯示272例(544耳)中有鼓室積液209例(396耳)(72.79%,396/544),其中,A組37例(65耳),佔34.57%(65/188),B組172例(331耳),佔92.98%(331/356),以上均經手術證實鼓室有積液;兩組中B型鼓室導抗圖377耳,其中,經CT及手術證實鼓室有積液的共373耳(98.94%,373/377),其中A組61耳(93.85%,61/65),B組312耳(100%,312/312),B組B型鼓室圖對中耳積液的暘性預測值高于A組(P＜0.01);C型鼓室導抗圖73耳中,峰壓值小于-200 daPa的14耳及鐙骨肌反射未引齣的51耳中23耳經CT及手術證實鼓室有積液,鐙骨肌反射可引齣的22耳鼓室均無積液.CT髮現B組有2例(4耳)前庭水管擴大和1例(2耳)耳蝸畸形.結論 對于腺樣體肥大兒童,B型鼓室導抗圖對中耳積液的預測值高,C型鼓室導抗圖峰壓值負于-200 daPa不排除鼓室積液,應以CT作最終確認.
목적 탐토선양체비대대인동중이공능적영향.방법 회고성분석272례(544이)선양체비대환인적림상자료,환인년령2～12세,평균6.3세,분위주소무은력하강조(A조)94례(188이)화주소유은력하강조(B조)178례(356이),균우선양체적제술전행고막경、성도항화중이CT검사.결과 CT현시272례(544이)중유고실적액209례(396이)(72.79%,396/544),기중,A조37례(65이),점34.57%(65/188),B조172례(331이),점92.98%(331/356),이상균경수술증실고실유적액;량조중B형고실도항도377이,기중,경CT급수술증실고실유적액적공373이(98.94%,373/377),기중A조61이(93.85%,61/65),B조312이(100%,312/312),B조B형고실도대중이적액적양성예측치고우A조(P＜0.01);C형고실도항도73이중,봉압치소우-200 daPa적14이급등골기반사미인출적51이중23이경CT급수술증실고실유적액,등골기반사가인출적22이고실균무적액.CT발현B조유2례(4이)전정수관확대화1례(2이)이와기형.결론 대우선양체비대인동,B형고실도항도대중이적액적예측치고,C형고실도항도봉압치부우-200 daPa불배제고실적액,응이CT작최종학인.
Objective To explore the influence of adenoid hypertrophy on the state of the middle ear in children.Methods Two hundred and seventy two adenoid hypertrophy patients,aged from 2 to 12 years old,were examined with otoscopy,tympanometry and temporal bone computered tomography before adenoidectomy.The average age of the patients was 6.3 years old.These patients were divided into two groups:Group A contained 94 normal hearing patients(188 ears),Group B 178 patients(356 ears) containing of hearing loss.Results Out of the temporal bone computed tomography (CT) revealed that 209 patients(396 ears) had middle ear effusions in(72.79%,396/544ears),and 37 patients(65/188 ears,34.57%) hydrotympanum in Group A and 172 patients(331/356 ears,92.98%) in Group B.All the 396 ears effusion were confirmed by operation.Three hundred seventy three ears effusion were confirmed by the CT and operation in the two groups,377 ears with B type tympanogram(373/377,98.94%),93.85%(61/65 ears) in Group A,100%(312/312 ears) in Group B,respectively.The positive predictive value for middle ear effusion of the B-type tympanogram was higher in Group B than in Group A(P＜0.01).Fourteen ears with peak pressure ＜-200 daPa revealed hydrotyrnpanum and 23 ears with normal acoustic stapedius reflex revealed no fluid by CT and operation in 73 ears with C-type tympanogram.CT also revealed two patients suffered from large vestibular aqueduct syndrome and one with cochlear malformation in Group B.Conclusion Type B tracing tympanogram has a high positive predictive value for middle ear effusion in adenoid hypertrophy children.Type C tympanogram could not exclude effusion when the peak pressure is＜-200 daPa.CT is the best tool for identifying hydrotympanum.
