頻譜差聲反射檢查與聲阻鼓室圖對於偵測中耳積液之比較

Comparison of Spectral Gradient Acoustic Reflectometry and Tympanometry for Detection of Middle Ear Effusion

朱水松(Swei-Song Chu) ； 林凱南(Kai-Nan Lin) ； 許權振(Chuan-Jen Hsu)

《台灣醫學》 5卷1期 (2001/01) Pp. 38-44

https://doi.org/10.6320/FJM.2001.5(1).05

摘要

Spectral gradient acoustic reflectometry (SG-AR) and tympanometry in diagnosing middle ear effusion (MEE) were validated. From Aug 1, 1999 to Oct 1, 2000, myringotomy under microscopy with or without ventilating tube insertion was performed in 186 ears of 95 patients under the diagnosis of middle ear effusion. Tympanometry and SG-AR were examined for all ears one day before myringotomy. The results showed that, the incidence of MEE for type A, C1, C2, B1, and B2 tympanograms were 0%, 57%, 74%, 77%, 96%, respectively. Corresponding values for SG-AR level 1 to 5 were 4%, 50%, 100%, 100% and 100%, respectively. The results demonstrated that tympanometry, when validated by myringotomy finding under microscopy, detected MEE with 96% sensitivity, and 38% specificity when type B and C2 were considered as evidence of MEE. Corresponding values for SG-AR were 92% and 100% when a cut-off of a 70-degree spectral gradient angle was used. The present results were somewhat different from those of earlier studies and demonstrated that the test efficacy and ease of use of SG-AR was better than tympanometry for detecting MEE. It is our experience that the test efficacy of SG-AR would be increased if we keep the tested ears at a lower position and make the multiple measurements by changing the position and direction of the probe tip of the instrument while performing examination with SG-AR.

關鍵字

聲阻鼓室圖 ； 頻譜差聲反射檢查 ； 中耳積液

並列摘要

Spectral gradient acoustic reflectometry (SG-AR) and tympanometry in diagnosing middle ear effusion (MEE) were validated. From Aug 1, 1999 to Oct 1, 2000, myringotomy under microscopy with or without ventilating tube insertion was performed in 186 ears of 95 patients under the diagnosis of middle ear effusion. Tympanometry and SG-AR were examined for all ears one day before myringotomy. The results showed that, the incidence of MEE for type A, C1, C2, B1, and B2 tympanograms were 0%, 57%, 74%, 77%, 96%, respectively. Corresponding values for SG-AR level 1 to 5 were 4%, 50%, 100%, 100% and 100%, respectively. The results demonstrated that tympanometry, when validated by myringotomy finding under microscopy, detected MEE with 96% sensitivity, and 38% specificity when type B and C2 were considered as evidence of MEE. Corresponding values for SG-AR were 92% and 100% when a cut-off of a 70-degree spectral gradient angle was used. The present results were somewhat different from those of earlier studies and demonstrated that the test efficacy and ease of use of SG-AR was better than tympanometry for detecting MEE. It is our experience that the test efficacy of SG-AR would be increased if we keep the tested ears at a lower position and make the multiple measurements by changing the position and direction of the probe tip of the instrument while performing examination with SG-AR.

並列關鍵字

tympanogram ； spectral gradient acoustic reflectometry ； middle ear effusion