- 期刊
台灣多頻率鼓室圖在耳硬化症患者的診斷價值
Diagnostic Value of Multi-frequency Tympanometry in Otosclerosis in Taiwan
摘要
BACKGROUND: Otosclerosis presents with progressive hearing impairment of unknown etiology. Results from pure tone audiometry demonstrate that this condition evolves from conductive hearing loss in early stages to mixed or sensorineural hearing loss in later stages. Eventually the diagnosis is depended on experienced otologist and exploratory tympanotomy. The Schwartze sign, Carhart notch, type As tympanogram and HRCT of ear in clinical practice are used for diagnosis of otosclerosis, but they are unable to confirm the diagnosis before surgery. The principle of multi-frequency tympanometry applied to otosclerosis is that as middle ear stiffness increases, so too does resonance frequency. The purpose of this study was to establish the resonance frequency of multi-frequency tympanometry in the diagnosis of otosclerosis in order to increase the diagnostic accuracy and value of multi-frequency tympanometry in Taiwan.METHODS: A retrospective study of surgically-confirmed otosclerosis cases and a normal-hearing control group was implemented to determine individual ranges in multifrequency tympanometry.RESULTS: From 1998 to 2011, we collected multi-frequency tympanometry data from 28 ears surgically confirmed to have otosclerosis, and compared them with those from 56 control ears. In otosclerosis cases, the average value of the resonance frequency was 1153.57±319.99 Hz. In controls, this value was 766.96±204.11 Hz (p＜0.01). The resonance frequency of multi-frequency tympanometry ranged from 1029 Hz to 1277 Hz in otosclerosis cases (95% confidence interval). With a cutoff value of 975 Hz, the sensitivity was 75% and the specificity was 82% in diagnosing otosclerosis.CONCLUSIONS: Multi-frequency tympanometry has advantages over conventional tympanometry for the diagnosis of otosclerosis. We hope this study will increase the application of this technology for diagnosing otosclerosis and establishing appropriate cutoff values in Taiwan.
並列摘要
BACKGROUND: Otosclerosis presents with progressive hearing impairment of unknown etiology. Results from pure tone audiometry demonstrate that this condition evolves from conductive hearing loss in early stages to mixed or sensorineural hearing loss in later stages. Eventually the diagnosis is depended on experienced otologist and exploratory tympanotomy. The Schwartze sign, Carhart notch, type As tympanogram and HRCT of ear in clinical practice are used for diagnosis of otosclerosis, but they are unable to confirm the diagnosis before surgery. The principle of multi-frequency tympanometry applied to otosclerosis is that as middle ear stiffness increases, so too does resonance frequency. The purpose of this study was to establish the resonance frequency of multi-frequency tympanometry in the diagnosis of otosclerosis in order to increase the diagnostic accuracy and value of multi-frequency tympanometry in Taiwan.METHODS: A retrospective study of surgically-confirmed otosclerosis cases and a normal-hearing control group was implemented to determine individual ranges in multifrequency tympanometry.RESULTS: From 1998 to 2011, we collected multi-frequency tympanometry data from 28 ears surgically confirmed to have otosclerosis, and compared them with those from 56 control ears. In otosclerosis cases, the average value of the resonance frequency was 1153.57±319.99 Hz. In controls, this value was 766.96±204.11 Hz (p＜0.01). The resonance frequency of multi-frequency tympanometry ranged from 1029 Hz to 1277 Hz in otosclerosis cases (95% confidence interval). With a cutoff value of 975 Hz, the sensitivity was 75% and the specificity was 82% in diagnosing otosclerosis.CONCLUSIONS: Multi-frequency tympanometry has advantages over conventional tympanometry for the diagnosis of otosclerosis. We hope this study will increase the application of this technology for diagnosing otosclerosis and establishing appropriate cutoff values in Taiwan.
延伸閱讀
- Chen, S. M., Wang, W. H., & Huang, C. C. (2016). 比較60歲以上病患在接受軟骨內置氏鼓室成型術後短長期之聽力結果. 台灣耳鼻喉頭頸外科雜誌, 51(2), 118-126. https://doi.org/10.6286/2016.51.2.118
- 劉殿楨（1999）。鼓膜穿孔患者配戴助聽器後功能性增益與塞入性增益之比較。中華民國耳鼻喉科醫學雜誌，34(6)，462-466。https://doi.org/10.6286/1999.34.6.462
- 羅仁成、張卉芝、王文弘、黃建嘉（2015）。70歲以上患者接受內嵌式軟骨鼓室成形術後之聽力分析。台灣耳鼻喉頭頸外科雜誌，50(3)，153-158。https://doi.org/10.6286/2015.50.3.153
- Lin, K. P., Yeh, T. P., Kang, Y. W., Tseng, J. J., Tseng, Y. H., Chang, K. C., & Young, K. C. (2014). Evaluation of Macrocytosis in Taiwan, an Area with High Prevalence of Chronic Viral Hepatitis. Journal of Biomedical & Laboratory Sciences, 26(4), 139-146. https://www.airitilibrary.com/Article/Detail?DocID=10137653-201412-201501060008-201501060008-139-146
- Huang, C. H. (2016). Prevalence and predictors of hypovitaminosis D among the elderly in Southern Taiwan [master's thesis, Kaohsiung Medical University]. Airiti Library. https://www.airitilibrary.com/Article/Detail?DocID=U0011-2006201616364900