【摘要】 目的研究咽鼓管测压仪(TMM)对分泌性中耳炎(OME)患者咽鼓管功能的测试评估。方法对36例(64耳)OME患者及35例(70耳)正常对照组进行TMM测试,结果以三种压力下(30mbar、40mbar、50mbar)R值显示(R≤1表示咽鼓管正常开放;R>1或未检测到R表示咽鼓管开放延迟或阻塞);同时进行主观Valsalva,声导抗,咽鼓管评分(ETS)和咽鼓管功能障碍问卷-7(ETDQ-7)评估。结果受试者在TMM30、40和50mbar压力下均观察到咽鼓管开放受限,对照组分别为10%,2.86%和1.43%,OME组分别为78.12%,71.83%,和68.75%,两组比较差异显著(30mbar:χ~2=63.479 P=0.000;40mbar:χ~2=69.273 P=0.000;50mbar:χ~2=67.934 P=0.000);咽鼓管开放受限在组内三个压力之间比较,对照组存在显著差异(χ~2=9.055 P=0.011)而OME组无统计学意义(χ~2=1.477 P=0.478)。OME患者Valsalva结果与TMM 30mbar测试结果一致性较好(χ~2=16.663 P=0.000),与40和50mbar结果一致性较差(χ~2=3.322P=0.068和χ~2=2.167 P=0.141)。ETS评分与ETDQ-7评分的相关性分析显示两者呈负相关(r=-0.493,P=0.000)。结论 TMM结果显示OME患者咽鼓管功能开放障碍,其30mbar时测试结果与Valsalva结果有较好的一致性,ETS与ETDQ-7评分结果呈负相关。更多还原

【Abstract】 Objective To report eustachian tube function evaluation results in patients with otitis media with effusion(OME) by tubomanometry(TMM). Methods Thirty six patients(64 ears) with OME and 35 normal controls(70 ears) were tested by TMM, with R≤1 representing normal eustachian tube opening and R>1 or no R representing eustachian tube opening delay or failure. In addition, data of Valsalva maneuver, impedance audiometry, eustachian tube score(ETS) and eustachian tube dysfunction questionnaire-7(ETDQ-7) were also collected. Results For pressures at30, 40 and 50 mbar, impeded eustachian tube opening was seen in 10%, 2.86% and 1.43% of the controls, and 78.12%,71.83% and 68.75% of the OME patients(χ~2=63.479, P=0.000; χ~2=69.273, P=0.000; and χ~2=67.934, P=0.000), respectively. When compared among the pressures, the rate of impeded eustachian tube opening showed differences for different pressures in the control group(χ~2=9.055, P=0.011), but not in the OME group(χ~2=1.477, P=0.478). In patients with OME, Valsalva results were consistent with TMM results at 30 mbar(χ~2=16.663, P=0.000), but not with TMM results at40 or 50 mbar(χ~2=3.322, P=0.068 and χ~2=2.167, P=0.141). ETS scores were negatively correlated to ETDQ-7 scores(r =-0.493, P=0.000). Conclusion TMM can identify eustachian tube dysfunction in patients with OME, with results at30 mbar showing good agreement with Valsalva results. In patients with OME, ETS scores are negatively correlated with ETDQ-7 scores.更多还原