CAJ | 학술논문

目的：探讨腺样体肥大患儿的不同鼓室图与分泌性中耳炎的关系及分泌性中耳炎的诊断。方法对2009年1月-2011年6月期间本院收治的328例腺样体肥大患儿(包括单纯腺样体肥大及合并有慢性扁桃体炎及扁桃体肥大者)的病例资料进行回顾性分析。分析统计分泌性中耳炎的发病率及声导抗测试诊断分泌性中耳炎的阳性率。结果328例腺样体肥大患儿中有105例最终经鼓膜穿刺或鼓膜置管确诊为分泌性中耳炎（32.31%）；声导抗测试鼓室导抗图表现为B型者89例152耳，其中最终确诊为分泌性中耳炎者为86例147耳，阳性率为96.63%；C导抗图（负压在-150dapa以上）者33例49耳，其中最终确诊为分泌性中耳炎者为16例20耳，阳性率为40.82%；As导抗图2例2耳亦最终确诊为分泌性中耳炎。结论对于腺样体肥大患儿不论主诉有无听力下降，常规进行声导抗测试，同时结合认真的体格检查及电耳镜或耳内镜检查，可大大降低小儿分泌性中耳炎的误诊率。
목적：탐토선양체비대환인적불동고실도여분비성중이염적관계급분비성중이염적진단。방법대2009년1월-2011년6월기간본원수치적328례선양체비대환인(포괄단순선양체비대급합병유만성편도체염급편도체비대자)적병례자료진행회고성분석。분석통계분비성중이염적발병솔급성도항측시진단분비성중이염적양성솔。결과328례선양체비대환인중유105례최종경고막천자혹고막치관학진위분비성중이염（32.31%）；성도항측시고실도항도표현위B형자89례152이，기중최종학진위분비성중이염자위86례147이，양성솔위96.63%；C도항도（부압재-150dapa이상）자33례49이，기중최종학진위분비성중이염자위16례20이，양성솔위40.82%；As도항도2례2이역최종학진위분비성중이염。결론대우선양체비대환인불론주소유무은력하강，상규진행성도항측시，동시결합인진적체격검사급전이경혹이내경검사，가대대강저소인분비성중이염적오진솔。
Objective To study the relationship between adenoid vegetation and secretory otitis media in children and its diagnosis. Methods A retrospective study was carried out among 328 children with adenoid vegetation (both simple ade-noid vegetation and those associated with chronic tonsillitis and tonsillar hypertrophy) treated from August 2010 to May 2012. The incidence of secretory otitis media and the rate of positive diagnostic tympanometry were analyzed. Results Secre-tory otitis media was diagnosed in 105 cases (32.31%) by tympanic membrane puncture or tympanostomy tube. Tympano-gram was type B in 89 cases (152 ears), of which secretory otitis media was confirmed in 86 cases (147 ears) yielding a posi-tive rate of 96.63%(147/152). Tympanogram was type C in 33 cases (49 ears), of which the diagnosis of secretory otitis me-dia was confirmed in 16 cases (20 ears), yielding a positive rate of 40.82%(20/49). The diagnosis of secretory otitis media was also confirmed in 2 cases (2 ears) with type As tympanograms. Conclusions Complaint of hearing loss or not, children with adenoid vegetation should be checked with routine tympanometry. Careful physical examination, electric otoscopy or ear endoscopy combined with tympanometry can greatly reduce the rate of missed diagnosis of secretory otitis media.