成人分泌性中耳炎鼓室积液诊断-耳鼻咽喉-头颈外科专业论文.docx

DIAGNOSIS OF HYDROTYMPANUM FOR ADULT OTITIS MEDIA WITH EFFUSION ABSTRACT Objective: To analyze the appearances of pure-tone hearing threshold ,middle ear function and temporal bone CT of adult otitis media with effusion(OME) and evaluate the value of pure-tone audiometry,middle ear function analysis and temporal bone CT in the diagnosis of hydrotympanum for adult OME . Methods: The clinical data of 108 adult patients(131 ears) with suspected OME was collected since December 2007 to December 2008 in our department. All of them were taken pure-tone audiometry, middle ear function analysis ,and 30 of them were taken temporal bone CT .Setting tympanotomy/myringotomy with grommet insertion as the golden standard,we analyzed the value of pure-tone audiometry, middle ear function analysis and temporal bone CT in the diagnosis of hydrotympanum for adult OME. Results: 1.The clinical appearances of adult OME: Among 131ears,94 ears were diagnosed as OME .0 ear presented as normal hearing threshold,80 ears presented as conductive deafness, 72.34% presented as mild～moderate conductive deafness.14.89% also presented as mixed deafness. The tympanograms of ears with OME presented as type “B” （44.68%）、 “C” （50.00%，） and “As” （ 5.32% ） .98.94% I- and Cs-acoustic stapedius reflex disappeared. Temporal bone CT should present as soft tissue intensity in mastoids and middle ear cavities without destruction of bone and auditory ossicles. 2. The value of pure-tone audiometry, middle ear function analysis and temporal bone CT in the diagnosis of hydrotympanum for adult OME:Among 131 suspected ears ,when the hearing threshold was normal, the positive percentage of tympanocentesis was 0.00%. When the hearing threshold was abnormal, the positive percentage of tympanocentesis was 75.81%.The higher average hearing threshold at language frequency,the higher possibility of the presence of hydrotympanum.The sensitivity rate of pure-tone audiometry in the diagn