Objective To explore the clinical diagnosis and audiological characteristics of otitis media with effusion ( OME) in elder adenoid hypertrophy children and to compare the various assessment methods. Methods Data of 80 candidates aged from 7 to 12 years who had undergone adenoidectomy were retrospectively analyzed. Otoscopy, tympanometry, pure tone audiometry(PTA) and CT were performed in all children before adenoidectomy. Results One hundred and five in 160 ears (65.63%) revealed middle ear effusion (MEE) by CT and confirmed by myringotomy, 98. 10% ( 103/105) of ears were confirmed to have MEE by "Type B" tracing tympanogram. "Type B" tracing tympanogram in the diagnosis of MEE have no difference with golden standard and CT(P >0.05). Adenoid hypertrophy children without MEE showed normal hearing by PTA. But there were 93. 33% (98/105) ears with hearing loss, in which 12. 38% (13/105) ears with MEE showed bone conduction hearing loss. Conclusions Tympanometry should be applied in the elder adenoid hypertrophy children to exclude OME before adenoidectomy. Adenoid hypertrophy children with OME could lead to hearing loss including bone conduction threshold shift. OME was a major risk factor of hearing loss in children and need to be aware of intervening the presence or development of it.%目的 探讨7～12岁大龄儿童腺样体肥大合并分泌性中耳炎的临床诊断与听力特点.方法 回顾分析80例(160耳)确诊腺样体肥大拟手术患儿的临床资料,患儿年龄7～12岁,均于腺样体摘除术前行鼓膜镜、声导抗、纯音测听和中耳CT检查了解中耳积液及听力情况.结果 CT显示80例(160耳)中有鼓室积液61例(105耳)(65.63%,105/160),以上均经鼓膜穿刺证实鼓室有积液;B型声导抗图105耳,其中,经CT及鼓膜穿刺证实鼓室有积液的共103耳(98.10%,103/105).B型鼓室图对中耳积液的阳性预测值与CT、鼓膜穿刺金标准比较无明显差异(P>0.05);纯音测听示腺样体肥大不伴有中耳积液患儿听力基本正常,98耳合并中耳积液纯音测听显示有气导听力下降(93.33%,98/105),其中有13耳有骨导听力的下降(12.38%,13/105).结论 腺样体肥大儿童手术前应常规行声导抗检查排除是否合并分泌性中耳炎,合并分泌性中耳炎患儿听力损失明显,同时会伴有骨导阈值升高,是可能导致儿童感音神经性耳聋的危险因素,应该及早干预,可避免病情发展.
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