中耳功能正常与异常婴儿的宽频声导抗能量吸收率特性研究

摘要

目的：对比中耳功能正常与异常婴儿宽频声导抗（wideband acoustic immittance ，WAI）能量吸收率（wideband absorbance ，WBA）的差异，探讨宽频声导抗对婴儿中耳功能诊断的作用。方法根据高频（1 kHz）声导抗（high frequency tympanometry ，HFT ）、畸变产物耳声发射（DPOAE）及听性脑干反应（ABR）结果将3～12月龄婴儿46例分为中耳功能正常组31例（50耳）和中耳异常组15例（20耳），用96 dB peSPL 的宽频短声（频率范围226～8000 Hz）对两组进行宽频声导抗测试，比较两组能量吸收率特性，分析中耳功能对不同频率能量吸收率的影响。结果无论外耳道压力为峰压还是0 daPa时，除8000 Hz外，中耳功能正常组婴儿的宽频声导抗能量吸收率均高于中耳功能异常组，且2000 Hz处两者差异最大。当外耳道压力为峰压时，中耳功能正常组与异常组226～6727 Hz WBA差异均有统计学意义（P＜0．05）；当外耳道压力为0 daPa时，中耳功能正常组与异常组500～6727 Hz WBA差异有统计学意义（P＜0．05）。结论中耳功能正常与异常婴儿宽频声导抗能量吸收率差异有统计学意义，宽频声导抗可作为有效检测婴儿中耳功能的方法之一。%Objective The purpose of this study was to examine the test performance of wideband absorbance (WBA)to assess the infants with middle ear dysfunctions .Methods Fifty normal ears and 20 impaired middle ears of infants aged 3 to 9 months were included .The middle ear function was examined according to the results of high frequency(1 000 Hz) tympanometry(HFT) ,distortion product otoacoustic emission(DPOAE) and auditory brain‐stem response(ABR) tests .Wideband acoustic immittance was performed and their characteristics at different mid‐dle ear status were assessed .Results The results revealed that wideband absorbance of normal ears were higher than dysfunction middle ear at all test frequencies except 8 000 Hz .The difference of WBA between normal and dys‐functional middle ear was the largest at the frequency of 2 000 Hz .The differences were statistically significant (P<0 .05) at frequencies 226~6 727 Hz when the external ear canal was at tympanometric peak pressure .The differ‐ences were statistically significant (P<0 .05) at frequencies 500~6 727 Hz when the external ear canal was at the pressure of 0 daPa .Conclusion There were significant wideband absorbance differences between normal infants and those with middle ear dysfunctions .The results suggest that wideband absorbance may be a useful diagnostic tool in the assessment of middle ear disorder for infants .