声反射在成人分泌性中耳炎中的诊断价值

The diagnostic value of acoustic reflex for secretory otitis media in adults

摘要:

目的提高耳科门诊成人分泌性中耳炎中耳积液的检出率，探讨声反射在协助诊断分泌性中耳炎是否伴有中耳积液中的临床价值。方法回顾性分析耳鼻咽喉科门诊169例确诊为分泌性中耳炎伴有中耳积液的成年患者的临床资料，并对听力正常与听力下降患者的鼓室图、同侧声反射及纯音测听等资料进行对比。结果169例(237耳)经鼓膜穿刺证实为中耳积液的患者中，223耳(94.1%)未引出声反射，14耳(5.9%)引出声反射；鼓室图异常200耳(84.4%)，正常者37耳(15.6%)；216耳(91.1%)有传导性听力下降，21耳(8.9%)听力正常。不论听力是否下降，同侧声反射的未引出率均高于异常鼓室图的概率(P<0.05)；在不同听力及不同类型鼓室图中，声反射的未引出率没有差异(P>0.05)，具有无创、快捷及客观等优点，能更好的帮助临床工作者评估分泌性中耳炎的疗效及预后。结论声反射能协助提高成人分泌性中耳炎伴中耳积液的检出率，具有无创、快速及客观等优点，能更好地帮助临床工作者评估分泌性中耳炎的疗效及预后。

Abstract:

Abstract:ObjectiveTo prompt the diagnosis of otitis media with middle ear effusion in the ENT outpatient department, and to explore the clinical value of acoustic reflex in the diagnosis of otitis media with effusion.MethodsThe clinical data of 169 adult patients diagnosed with secretory otitis media with middle ear effusion in the ENT outpatient department were retrospectively analyzed, and the tympanogram, ipsilateral acoustic reflex and pure tone audiometry were compared between normal and Impaired Hearing.ResultsOf the 169 cases (237 ears) with middle ear effusion confirmed by tympanic puncture, 223 ears (94.1%) were not elicited acoustic reflex, 14 ears(5.9%) were elicited; 200 ears(84.4%) were with abnormal tympanogram, 37 ears(15.6%) were normal; conductive hearing loss was observed in 216 ears (91.1%) and normal hearing in 21 ears (8.9%). Regardless of hearing loss, the rate of negative ipsilateral acoustic reflex was significantly higher than the ratio of abnormal tympanum (P<0.05). There was no difference in the ratio of negative acoustic reflex between the groups with different hearing levels and tympanograms(P>0.05).ConclusionAcoustic reflex is a favorable way to help diagnose otitis media with middle ear effusion in adults. It has the advantages of noninvasive, rapid and objective, which can better help clinical workers to evaluate the efficacy and prognosis of secretory otitis media.