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目的:探讨儿童分泌性中耳炎(SOM)鼓膜置管后中耳功能综合评价的方法和临床意义。方法:选择31例(43耳)临床诊断为SOM的患儿,分别在鼓膜置管术前及术后1个月,进行纯音听阈测试、畸变产物耳声发射(DPOAE)、鼓室导抗图(记录外耳道容积,ECV)测试;术后1个月加咽鼓管功能正负压平衡测试,并在显微镜下观察置管情况。结果:置管后1个月,39耳置管通畅者ECV>2.0ml,听力比置管前明显提高;DPOAE引出率及部分频率幅值提高,与置管前比较,差异有统计学意义(P<0.01或P<0.05);咽鼓管功能尚无完全正常。结论:应用ECV、纯音听阈测试、DPOAE以及咽鼓管功能测试对患儿鼓膜置管术后中耳功能的恢复情况进行综合评价,具有临床指导意义。
Objective: To investigate the method and clinical significance of comprehensive evaluation of middle ear function after tympanic membrane insertion in children with secretory otitis media (SOM). Methods: Totally 31 children (43 ears) with SOM were selected for this study. Pure tone audiometry, distortion product otoacoustic emissions (DPOAE) and tympanogram were used before and after tympanoplasty Record the external auditory meatus volume, ECV) test; 1 month after the eustachian tube positive and negative pressure balance test, and observed under the microscope catheterization. Results: At 1 month after catheterization, ECV> 2.0ml in 39 ears with patency was significantly higher than that before catheterization (P <0.05). The DPOAE extraction rate and partial frequency amplitude were significantly higher than those before catheterization P <0.01 or P <0.05); eustachian tube function is not yet fully normal. Conclusion: The application of ECV, pure tone hearing threshold test, DPOAE and Eustachian tube function test in children with tympanic membrane after surgery to assess the recovery of middle ear function, has clinical significance.