Detection of eustachian tube openings by tubomanometry in adult otitis media with effusion
Detection of eustachian tube openings by tubomanometry in adult otitis media with effusion
复制标题
成人渗出性中耳炎的管测压法检测咽鼓管开口
DOI：
10.1007/s00405-016-3938-0
复制
发表时间：
2016-10-01
影响因子：
2.6
通讯作者：
Yin, Shankai
中科院分区：
文献类型：
--
作者：
Liu, Panpan;Su, Kaiming;Yin, Shankai
渗出性中耳炎(OME)是一种常见病，咽鼓管(ET)功能障碍与OME的发病密切相关，但缺乏客观的ET功能评价工具。为评价成人渗出性中耳炎(OME)患者的鼓室传导速度(ET)，应用TMM和鼓室导纳检测123耳，其中OME患者63耳，对照组60耳。通过R值和ET评分评价ET的通畅性，并与鼓室导抗图结果进行比较。采用咽鼓管功能障碍问卷(ETDQ-7)评定OME患者的症状严重程度。结果显示，在30、40和50 mbar压力下，经TMM检测ET受限开放或阻断的比率分别为10、5和0%(对照组)和76.19%、66.7%和57.97%(各压力组P<0.05)。B、C型鼓室导抗图组分别为77.42%、71.97%和61.29%，C型鼓室导抗图组分别为75%、62.5%和46.87%，各测试压力下两组间差异无统计学意义(p分别为0.821、0.246和0.516)。OME患者ETDQ-7评分平均为16.40±10.72，与30、40 mbar的ET评分呈显著负相关(30 mbar：相关系数−0.29，p=0.0.025；40 mbar：相关系数−0.28；p=0.030)，但与50 mbar的ET评分无显著相关性(相关系数−0.013，p=0.924)。这些结果表明，大多数成人OME患者在用这种创新的、半客观的TMM评估时，存在ET阻塞或延迟开放，在评估OME患者的TMM结果时，应考虑测试压力。
Otitis media with effusion (OME) is a common disease and eustachian tube (ET) dysfunction is widely known to be related to the incidence of OME; however, objective evaluation tools for ET function are lacking. To evaluate ET openings by tubomanometry (TMM) in adult patients with otitis media with effusion (OME), the ET patency of 123 ears, including 63 ears of OME patients and 60 control ears, were tested using TMM and tympanometry. ET patency was evaluated by the R value and ET score, and was compared to the tympanogram results. The eustachian tube dysfunction questionnaire (ETDQ-7) was used to assess the severity of the symptoms in OME patients. The results showed that the rates of restricted opening or blocked ET under pressures of 30, 40, and 50 mbar by TMM testing were 10, 5, and 0 %, respectively (control group) and 76.19, 66.7, and 57.97 %, respectively (OME group) (p< 0.05 for all pressure groups). However, the rates were 77.42, 71.97, and 61.29 % in the type B tympanogram group, and 75, 62.5, and 46.87 % in the type C tympanogram group; no significant difference was found at each testing pressure (p= 0.821, 0.246, and 0.516; respectively) between these tympanogram groups. The mean ETDQ-7 score in OME patients was 16.40 ± 10.72, which was significantly negatively correlated with the ET score at 30 and 40 mbar (30 mbar: correlation coefficient −0.29,p= 0.025; 40 mbar: correlation coefficient −0.28;p= 0.030), but not at 50 mbar (correlation coefficient −0.013,p= 0.924). These findings showed that ET blockage or delayed opening were found in most adult patients with OME when evaluated by this innovative and semi objective TMM, testing pressures should be considered when assessing the results of TMM in OME patients.