鼓室置管对儿童分泌性中耳炎中耳功能影响的研究

Effect of tympanostomy tube insertion on middle ear function in children with secretory otitis media

摘要:

目的 探讨鼓室置管治疗儿童分泌性中耳炎对中耳功能的影响。方法 选取47例58耳）临床诊断为分泌性中耳炎的患儿，分别在鼓室置管术前及术后1个月、6个月进行纯音测听、声导抗、畸变产物耳声发射（distortion product otoacoustic emission, DPOAE）检查和耳镜检查，以评估鼓室置管手术前后中耳功能的变化及术后的并发症。结果 鼓室置管术后1个月、6个月分别行耳镜和声导抗检查，均较术前听力明显提高。术后6个月与术后1个月检查结果比较，听力改变差异无统计学意义。与鼓室置管术前比较，DPOAE引出率及部分频率幅值提高，差异具有统计学意义。鼓室置管术后的并发症主要是中耳感染、分泌性中耳炎复发、鼓膜穿孔和鼓膜内陷。结论 鼓室置管治疗儿童分泌性中耳炎，应用检测纯音测听、声导抗、DPOAE和耳镜检查，了解鼓室置管术后的并发症情况，综合评价对中耳功能的影响，具有临床指导意义。 

Abstract:

Objective To investigate the effect of tympanostomy tube insertion on the middle ear function in children with secretory otitis media (SOM). Methods Pure tone audiometry, acoustic impedance, distortion product otoacoustic emission ( DPOAE) examination and otoscopy were carried out in 47 children (58 ears) with SOM before tube insertion, one month and 6 months after tube insertion respectively to evaluate the changes of middle ear function and surgical complications. Results One month and 6 months after tube insertion, hearing of children with catheter patency was significantly improved. In addition, the detection rate and amplitude of DPOAE were significantly increased. The difference of hearing 1 month and 6 months after tube insertion was statistically insignificant. Surgical and postoperative complications included middle ear infection, recurrent SOM, tympanic perforation and tympanic membrane retraction. Conclusion Pure tone audiometry, acoustic impedance, DPOAE and otoscopy are of clinical importance in evaluation of the middle ear function and incidence of sequelae in children with SOM after tympanostomy tube insertion. Tympanostomy tube insertion|Secretory otitis media|Pure tone audiometry| DPOAE