The Functions of the Middle Ears of Children with Adenoid Hypertrophy / 听力学及言语疾病杂志

ABSTRACT

Objective To explore the influence of adenoid hypertrophy on the state of the middle ear in children.Methods Two hundred and seventy two adenoid hypertrophy patients,aged from 2 to 12 years old,were examined with otoscopy,tympanometry and temporal bone computered tomography before adenoidectomy.The average age of the patients was 6.3 years old.These patients were divided into two groupsGroup A contained 94 normal hearing patients(188 ears),Group B 178 patients(356 ears) containing of hearing loss.Results Out of the temporal bone computed tomography (CT) revealed that 209 patients(396 ears) had middle ear effusions in(72.79%,396/544ears),and 37 patients(65/188 ears,34.57%) hydrotympanum in Group A and 172 patients(331/356 ears,92.98%) in Group B.All the 396 ears effusion were confirmed by operation.Three hundred seventy three ears effusion were confirmed by the CT and operation in the two groups,377 ears with B type tympanogram(373/377,98.94%),93.85%(61/65 ears) in Group A,100%(312/312 ears) in Group B,respectively.The positive predictive value for middle ear effusion of the B-type tympanogram was higher in Group B than in Group A(P＜0.01).Fourteen ears with peak pressure ＜-200 daPa revealed hydrotyrnpanum and 23 ears with normal acoustic stapedius reflex revealed no fluid by CT and operation in 73 ears with C-type tympanogram.CT also revealed two patients suffered from large vestibular aqueduct syndrome and one with cochlear malformation in Group B.Conclusion Type B tracing tympanogram has a high positive predictive value for middle ear effusion in adenoid hypertrophy children.Type C tympanogram could not exclude effusion when the peak pressure is＜-200 daPa.CT is the best tool for identifying hydrotympanum.