The Effects of Different Probe Tone and Tympanometric Admittance Measurement Methods to Otitis Media Prediction / 听力学及言语疾病杂志

ABSTRACT

Objective To explore the effects of different probe tone and tympanometric admittance measure-ment methods on the diagnose of otitis media prediction ,and to provide a clinical reference for the selection of probe tones and measurement method to apply to newborn infants .Methods Tympanograms with 226 Hz and 1 000 Hz probe tones were obtained from normal infants (142 ears) and infants with otitis media (90 ears) .Mean values , standard deviations ,the 90% range and 95% mean confidence interval were recorded as the variable to observe po-tential impacts on tympanometric admittance with 226 Hz probe tone and tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods respectively according to Linder/Jerger classification ,the Baldwin classification and baseline classification adapted from Baldwin .The four indexes were tested with compara-tive analysis .The area under ROC curve simultaneous detects the normal group and otitis media group ,with refer-ences to the accuracy of the detection method to disease (including specificity and sensitivity ) .Results In 1-to -3 month group ,tympanometric admittance with 226 Hz probe tone and tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods were 0 .83 ± 0 .29 ,0 .60 ± 0 .55 ,0 .74 ± 0 .56 ,0 .90 ± 0 .59 in nom-al infants and 0 .82 ± 0 .35 ,0 .01 ± 0 .06 ,-0 .24 ± 0 .15 ,-0 .29 ± 0 .21 in infants with OME ,respectively .The areas under ROC curve of the four kinds of measurement methods were 0 .507 ,0 .896 ,0 .976 ,0 .988 ,respectively .In 4 to 6 month group ,tympanometric admittance with 226 Hz probe tone and tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods were 0 .60 ± 0 .35 ,0 .55 ± 0 .58 ,0 .76 ± 1 .0 ,0 .86 ± 0 .72 in nomal infants and 0 .36 ± 0 .24 ,0 ± 0 ,-0 .34 ± 0 .16 ,-0 .44 ± 0 .28 in infants with OME ,respectively .The areas under ROC curve of the four kinds of measurement methods were 0 .749 ,0 .888 ,0 .969 ,0 .988 in 4 to 6 month infants ,re-spectively .Tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods were significantly better than that with 226 Hz probe tone .The areas under ROC curve of tympanometric peak admittance with 1 000 Hz probe tone by baseline classification adapted from Baldwin were bigger than others and the differences were significant(P0 .05) .Conclusion Tympanometric peak admittance with 1 000 Hz probe tone were better than that with 226 Hz probe tone to assess otitis media in 1~6 month infants .The baseline classification adapted from Baldwin was appropriate for the measurement of tympanometric peak admittance with 1 000 Hz probe tone .