儿童分泌性中耳炎诊断方法比较

发布时间：2018-05-30 06:04

  本文选题：分泌性中耳炎 + 耳内镜　； 参考：《听力学及言语疾病杂志》2017年06期

【摘要】：目的探讨耳内镜、颞骨高分辨率CT、鼓室声导抗及纯音测听等检查对儿童分泌性中耳炎(secretory otitis media,SOM)的诊断价值。方法对207例(414耳)腺样体肥大患儿分别行耳内镜、鼓室声导抗、纯音测听及颞骨高分辨率CT检查,以颞骨CT检查结果作为分泌性中耳炎的诊断标准,分别计算耳内镜、声导抗及纯音测听诊断分泌性中耳炎的准确度。结果 207例414耳中,CT诊断SOM(中耳积液)125耳(30.19%,125/414),其中116耳(92.80%,116/125)鼓膜穿刺证实有中耳积液;与颞骨CT结果比较,耳内镜(诊断中耳积液128耳,其中CT检查阴性4耳)、鼓室声导抗(B型导抗图133耳,其中CT检查阴性8耳)、纯音测听(0.5~4kHz气骨导差≥15dB 81耳,其中CT检查阴性2耳)三种检查诊断SOM的敏感性分别为99.20%(124/125)、100%(125/125)、63.20%(79/125),特异性分别为98.62%(285/289)、97.23%(281/289)、99.31%(287/289),诊断符合率分别为98.79%(409/414)、98.07%(406/414)、88.41%(366/414)。耳内镜下见鼓室积液联合B型鼓室导抗图诊断SOM的符合率(99.52%)高于任一种单项检查和其他任何两种联合检查。结论以耳内镜下见鼓室积液联合B型鼓室导抗图诊断分泌性中耳炎准确、安全。
[Abstract]:Objective to evaluate the diagnostic value of endoscopy, high resolution CTs of temporal bone, tympanic acoustic impedance and pure tone audiometry in secretory otitis mediaomus in children with secretory otitis media. Methods 207 children with adenoid hypertrophy were examined by endoscopy, tympanic acoustic conductance, pure tone audiometry and high resolution CT examination of temporal bone. The results of CT examination of temporal bone were used as diagnostic criteria for secretory otitis media. Accuracy of acoustic impedance and pure tone audiometry in diagnosis of secretory otitis media. Results CT scans of 414 ears of 207 cases diagnosed middle ear effusion (125 ears 30. 19 ears with 125 ears, 116 ears 92.80% 116 / 125), the middle ear effusion was confirmed by tympanic membrane puncture, and compared with temporal bone CT results, the ear endoscopy (diagnosis of middle ear effusion 128 ears), Among them, CT examination was negative in 4 ears, tympanic acoustical impedance map in 133 ears, CT examination negative in 8 ears, pure tone audiometry with 0.5 kHz air-bone conductance 鈮，

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