腺样体肥大患儿鼓室导抗图与分泌性中耳炎的关系探讨

摘要

目的：探讨腺样体肥大患儿的不同鼓室导抗图与分泌性中耳炎的关系。方法回顾性分析2009年1月～2011年6月收治的328例腺样体肥大患儿的临床资料，分析统计分泌性中耳炎的发病例（耳）数及声导抗测试诊断分泌性中耳炎的阳性率。结果328例腺样体肥大患儿中有104例（169耳）最终经鼓膜穿刺或鼓膜置管确诊为分泌性中耳炎（31．71％，104/328），其中鼓室导抗图为B型者89例152耳，最终确诊为分泌性中耳炎者为86例147耳，阳性率为96．71％（147/152）；鼓室导抗图为C型（负压在-150 daPa以上）者33例49耳，最终确诊为分泌性中耳炎者为16例20耳，阳性率为40．82％（20/49）；鼓室导抗图为A s型者2例2耳最终均确诊为分泌性中耳炎。结论腺样体肥大患儿无论有无听力下降主诉，均应行声导抗测试，B型鼓室导抗图对鼓室积液判断的准确率最高，C型次之，As型也有鼓室积液的可能。%Objective To explore the relationship between adenoid vegetation children with different types of tympanograms and secretory otitis media in children and diagnosis of secretory otitis media .Methods A retrospec-tive study was carried out among 328 cases with adenoid vegetation in children ,including simple adenoid vegetation and associated with chronic tonsillitis and tonsillar hypertrophy ,from August 2010 to May 2012 .The incidence of secretory otitis media and outcomes of tympanometry for the diagnosis were analyzed .Results 104 cases were diag-nosed with secretory otitis media by tympanic membrane puncture or tympanostomy tube in 328 cases with adenoid vegetation (32 .31% );86 cases (147 ears) were finally diagnosed as secretory otitis media among 89 cases (152 ears) with type B tympanogram (147/152 ,96 .63% );16 cases (20 ears) were finally diagnosed secretory otitis media among 33 cases (49 ears) with type C tympanogram (20/49 ,40 .82% );2 cases (2 ears) with type As tympa-nogram were finally diagnosed .Conclusion With or without complaint of hearing loss ,children with adenoid vegeta-tion should be checked by routine tympanometry .Careful physical examinations and electric otoscope or ear endosco-py combined tympanometry can greatly reduce the rate of misdiagnosis of secretory otitis media .