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目的:探讨负压型鼓室导抗图对成人鼓室积液的诊断价值。方法:采用美国GSI-TympstarⅡ型中耳分析仪,对所有疑似分泌性中耳炎的成人患者行声导抗检查,包括鼓室导抗图峰压、宽度、中耳共振频率及镫骨肌反射,选择其中为负压型鼓室导抗图的207耳行鼓膜穿刺,根据穿刺积液量将患耳分为无积液组(123耳)、少量积液组(45耳)及多量积液组(39耳),分别就3组患者的声导抗指标及同侧镫骨肌反射引出情况进行统计学分析。结果:无积液组的鼓室导抗图峰压、中耳共振频率与少量积液组和多量积液组之间的差异均有统计学意义(P<0.05或P<0.01);无积液组鼓室导抗图宽度与多量积液组之间的差异有统计学意义(P<0.01);3组间的同侧镫骨肌反射引出情况均差异有统计学意义(均P<0.01)。结论:鼓室导抗图峰压、宽度、中耳共振频率结合同侧镫骨肌反射对判断成人负压型鼓室导抗图的鼓室有无积液具有诊断价值。
Objective: To investigate the diagnostic value of negative pressure tympanogram in adult tympanic effusion. Methods: The American GSI-Tympstar II middle ear analyzer was used to perform acoustic impedance tests on all adult patients with suspected secretory otitis media, including the tympanogram peak pressure, width, middle ear resonance frequency and stapedius reflex, According to the amount of pricking fluid, the affected ear was divided into non-effusion group (123 ears), small amount of effusion group (45 ears) and large amount of effusion group (39 ears ), Respectively, three groups of patients with acoustic impedance and ipsilateral stapedius reflex lead to statistical analysis. Results: There was a significant difference in tympanogram peak pressure, middle ear resonance frequency, and a small amount of effusion group and a large amount of effusion group in no effusion group (P <0.05 or P <0.01) There was significant difference between the tympanogram width and the volume of effusion group (P <0.01). There was significant difference in the reflexes of the ipsilateral stapedius between the three groups (all P <0.01). Conclusion: The results of tympanogram peak pressure, width, middle ear resonance frequency and ipsilateral stapedius reflex have the diagnostic value to judge the presence or absence of fluid in the tympanic cavity of adult negative pressure tympanogram.