CAJ | 학술논문

目的：分析0-36个月婴幼儿226 Hz和1000 Hz探测音声导抗结果,探讨在临床上如何选择226 Hz和/或1000 Hz探测音声导抗方法将1645例（共3290耳）0-36个月婴幼儿按听力评估结果分为两个大组：听力正常组938例（1876耳）和听力异常组707例（1414耳），按月龄分为七个小组：第一组：新生儿（≦28天）54例（108耳），其中听力正常组34例（68耳）；第二组：2～3月龄355例(710耳)，其中听力正常组149例（298耳）；第三组：4～6月龄537例(1074耳)，其中听力正常组201例（402耳）；第四组：7～9月龄236例(472耳)，其中听力正常组143例（286耳）；第五组：10～12月龄97例(194耳)，其中听力正常组62例（124耳）；第六组：13～24月龄259例(518耳)，其中听力正常组249例（498耳）；第七组：25～36月龄107例(214耳)，其中听力正常组100例（200耳）。结果正常组226 Hz和1000 Hz探测音鼓室声导抗图均存在正峰，并且均以宽大的单峰型最多见，少数为双峰型.其中226 Hz单峰1403耳(74.79％)，双峰290耳(15.46％)；1000 Hz单峰1407耳(64.07％)，双峰175耳(5.17％).第一至第五月龄组组间1000Hz与226Hz探测音声导抗正常和异常结果均有统计学意义(P<0.05)。其中第一至第四月龄组1000Hz组一致率（97.06%,91.95%,91.04%,81.82%）均高于226Hz组(38.24%,68.46%,66.92%,66.78%)，第五月龄组226Hz组的一致率（95.16%）高于1000Hz组（58.87%）。第六至第七月龄组组间1000Hz与226Hz探测音声导抗正常和异常结果均有统计学意义(P<0.05)。结论单纯226 Hz探测音鼓室声导抗测试不能准确反映O～10月龄婴幼儿的中耳功能，1000 Hz探测音声导抗测试能更好的评估O～10月龄婴幼儿的中耳功能；；226 Hz探测音鼓室声导抗测试能客观反映11～36月龄婴幼儿的中耳功能。
목적：분석0-36개월영유인226 Hz화1000 Hz탐측음성도항결과,탐토재림상상여하선택226 Hz화/혹1000 Hz탐측음성도항방법장1645례（공3290이）0-36개월영유인안은력평고결과분위량개대조：은력정상조938례（1876이）화은력이상조707례（1414이），안월령분위칠개소조：제일조：신생인（≦28천）54례（108이），기중은력정상조34례（68이）；제이조：2～3월령355례(710이)，기중은력정상조149례（298이）；제삼조：4～6월령537례(1074이)，기중은력정상조201례（402이）；제사조：7～9월령236례(472이)，기중은력정상조143례（286이）；제오조：10～12월령97례(194이)，기중은력정상조62례（124이）；제륙조：13～24월령259례(518이)，기중은력정상조249례（498이）；제칠조：25～36월령107례(214이)，기중은력정상조100례（200이）。결과정상조226 Hz화1000 Hz탐측음고실성도항도균존재정봉，병차균이관대적단봉형최다견，소수위쌍봉형.기중226 Hz단봉1403이(74.79％)，쌍봉290이(15.46％)；1000 Hz단봉1407이(64.07％)，쌍봉175이(5.17％).제일지제오월령조조간1000Hz여226Hz탐측음성도항정상화이상결과균유통계학의의(P<0.05)。기중제일지제사월령조1000Hz조일치솔（97.06%,91.95%,91.04%,81.82%）균고우226Hz조(38.24%,68.46%,66.92%,66.78%)，제오월령조226Hz조적일치솔（95.16%）고우1000Hz조（58.87%）。제륙지제칠월령조조간1000Hz여226Hz탐측음성도항정상화이상결과균유통계학의의(P<0.05)。결론단순226 Hz탐측음고실성도항측시불능준학반영O～10월령영유인적중이공능，1000 Hz탐측음성도항측시능경호적평고O～10월령영유인적중이공능；；226 Hz탐측음고실성도항측시능객관반영11～36월령영유인적중이공능。
Objective To report results of tympanometry at 1000 Hz or 226 Hz in 1645 infants (0-36months). Methods Based on their hearing evaluation results, 1645 infants were divided into a normal hearing group (n=938, 1876 ears) and an ab-normal hearing group (n=938, 1414 ears). Within each group, cases were further divided into seven age groups, i.e. Group 1 (≦28days of age, n=54 [108 ears] with 34 [68 ears] in normal hearing group), Group 2 (2 to 3 months of age, n=355 [710ears] with 149 [298 ears] in normal hearing group), Group 3 (4 to 6 months of age, n=537 [1074 ears] with 201 [402 ears] in normal hear-ing group), Group 4 (7 to 9 months of age, n=236 [472 ears] with 143 [286 ears] in normal hearing group, Group 5 (10 to 12 months of age, n=97 [194 ears] with 62 [124 ears] in normal hearing group), Group 6 (13 to 24 months of age, n=259 [518 ears] with 249 [498 ears] in normal hearing group) and Group 7 (25 to 36 months of age, n=107 [214 ears] with 100 [200 ears] in nor-mal hearing group). Results Most cases in the normal hearing group showed single broad peak tympanograms with either 226 Hz or 1000 Hz probe tone. A small number of cases in the normal hearing group showed W-shaped tympangrams. With the 226 Hz probe gone, single peaked tympanograms occurred in 1403 ears (74.79%) while W-shaped tympanograms occurred in 290 ears (15.46%). With the 1000 Hz probe tone, single peaked tympanograms were seen in 1407 ears (64.07%) while W-shaped tympanograms were seen in 175 ears (5.17%). The rates of normal and abnormal results were different among groups 1 to 5 (P<0.05). Using the 1000 Hz probe tone, the rate of consistent results in groups 1 to 4 (97.06%, 91.95%, 91.04%and 81.82%re-spectively) were higher than using the 226 Hz probe tone (38.24%, 68.46%, 66.92%and 66.78%, respectively). The rate of con-sistent results in group 5 when using the 226 Hz probe tone (95.16%) was higher than when using the 1000 Hz probe tone (58.87%). In groups 6 and 7, the rates of normal and abnormal results were significantly different (P<0.05). Conclusions False negative rate can be high when using the 226 Hz probe tone in tympanometry in children younger than 10 months, and the 1000 Hz probe tone may be more suitable. The 226 Hz probe tone appears to better in children older than 10 months for tympanometry.