Preliminary study of the diagnostic value of wideband absorbance in adenoid hypertrophy children with type A tympanogram_Chinese Journal of Evidence-Based Medicine

Authors：

LI Hang ¹ , JIANG Wen ^1,2,3 , LIU Jie ¹ , LIN Huan ¹ ,  LIU Wen ^1,2 , QIAO Yuehua ^1,2,3

1. The First Clinical Medical College of Xuzhou Medical University, Xuzhou 221000, P. R. China;
2. The Otolaryngology Department of the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, P. R. China;
3. Jiangsu Artificial Hearing Engineering Laboratory, Xuzhou 221000, P. R. China;

Corresponding?author：

LIU Wen, Email: Liuwen1972@163.com

Keywords：

Adenoid hypertrophy; Wideband absorbance; Middle ear function; Principal component analysis; Regression model

DOI：

10.7507/1672-2531.202303142

Video：

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Objective To investigate the differences in middle ear function between adenoid hypertrophy (AH) children with type A tympanogram and normal children, and to evaluate the value of wideband acoustic immittance (WAI) in diagnosing middle ear dysfunction in AH children with type A tympanogram. Methods This retrospective cohort study included 96 children (192 ears) with AH and 40 healthy children (80 ears) as the control group. All children underwent pure tone audiometry, 226 Hz tympanometry, WAI, otoscopy, and electronic nasopharyngoscopy. Type A AH children were selected as the study group (AH group) to compare the 226 Hz tympanometry index and WAI between the two groups. A binary logistic regression model was constructed after dimensionality reduction by principal component analysis of the frequencies with statistical significance, and the diagnostic value of the model was evaluated by receiver operating characteristic (ROC) curve. Results There was no significant difference in 226 Hz tympanometry between the two groups (P>0.05). This study found that there were significant differences in WAI between children with AH and healthy children. Under tympanic peak pressure, the wideband absorbance (WBA) of the AH group was significantly higher than that of the control group at 226～630 Hz and 3 150～6 000 Hz; Under ambient pressure, the WBA of the AH group was significantly lower than that of the control group at 1 250～1 600 Hz and significantly higher than that of the control group at 4 000～6 000 Hz. The dimensionality of 15 statistically significant frequencies was reduced to 3 principal components (89.79% of the original information) by principal component analysis. The binary logistic regression model constructed after dimensionality reduction by principal component analysis had a high diagnostic value, with an AUC of 0.813, a sensitivity of 62.18%, and a specificity of 87.50%. Conclusion WAI can be used as an effective method for evaluating the middle ear function of AH children with type A tympanogram.

Citation： LI Hang, JIANG Wen, LIU Jie, LIN Huan, LIU Wen, QIAO Yuehua. Preliminary study of the diagnostic value of wideband absorbance in adenoid hypertrophy children with type A tympanogram. Chinese Journal of Evidence-Based Medicine, 2024, 24(1): 23-28. doi: 10.7507/1672-2531.202303142 Copy

1.	趙佳奇, 單麗華. 兒童腺樣體和扁桃體肥大治療理念新進展. 口腔醫學研究, 2021, 37(8): 693-695.
2.	劉燕, 魏萍, 寇巍, 等. 兒童腺樣體肥大與耳鼻咽喉科常見疾病關系的研究進展. 山東大學耳鼻喉眼學報, 2019, 33(4): 149-154.
3.	王夢航, 景紅, 郭紅光, 等. 鼻咽部數字化攝影及ETDQ-7量表評分對腺樣體肥大兒童的咽鼓管功能評價. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(1): 24-26.
4.	Margolis RH, Saly GL, Keefe DH. Wideband reflectance tympanometry in normal adults. J Acoust Soc Am, 1999, 106(1): 265-280.
5.	Iacovou E, Vlastarakos PV, Ferekidis E, et al. Multi-frequency tympanometry: clinical applications for the assessment of the middle ear status. Indian J Otolaryngol Head Neck Surg, 2013, 65(3): 283-287.
6.	徐繼峰, 蔣雯, 劉潔, 等. 寬頻聲導抗在中耳膽脂瘤與慢性化膿性中耳炎鑒別診斷中的價值. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(5): 376-381.
7.	劉潔, 蔣雯, 林歡, 等. 梅尼埃病患者寬頻聲導抗測試特點初步研究. 臨床耳鼻咽喉頭頸外科雜志, 2021, 35(12): 1068-1072.
8.	陳露靜, 蘭蘭, 黃鑫, 等. 耳硬化癥和中耳畸形患者的寬頻聲導抗研究. 中華耳科學雜志, 2020, 18(1): 57-62.
9.	Utama MAS, Kentjono WA, Ekorini HE. Association between adenoid-nasopharyngeal ratio and tympanogram width in adenoid hypertrophy patients. Asian J Oncol, 2022, 8(1): 42-46.
10.	陳紅, 廉興, 張國忠, 等. CT和電子鼻內鏡診斷兒童腺樣體肥大的價值觀察. 中國CT和MRI雜志, 2021, 19(5): 144-146.
11.	蘇仁杰. 1000Hz探測音聲導抗及其鼓室圖分類方法的研究進展. 醫學綜述, 2012, 18(19): 3269-3273.
12.	傅德印. 主成分分析中的統計檢驗問題. 統計教育, 2007, 96(9): 4-7.
13.	方琴, 陶朵朵. 蘇州市中小學生腺樣體肥大及并發分泌性中耳炎分析. 中國學校衛生, 2021, 42(11): 1728-1731,1735.
14.	姜文君, 黃寧靜, 田成華. 單側人工耳蝸植入兒童寬頻聲導抗測試聲能吸收率特征研究. 聽力學及言語疾病雜志, 2021, 29(4): 369-372.
15.	盛海斌, 周嵌, 李海峰, 等. 低齡兒童分泌性中耳炎寬頻聲導抗特點及臨床意義. 中華耳鼻咽喉頭頸外科雜志, 2021, 56(6): 579-585.
16.	丁璐, 王晨露, 史文迪. 大前庭水管綜合征患者鼓膜吸收率特征初探. 中華耳科學雜志, 2021, 19(1): 16-20.
17.	虞曉芬, 傅玳. 多指標綜合評價方法綜述. 統計與決策, 2004, (11): 119-121.
18.	Aithal V, Aithal S, Kei J, et al. Predictive accuracy of wideband absorbance at ambient and tympanometric peak pressure conditions in identifying children with surgically confirmed otitis media with effusion. J Am Acad Audiol, 2020, 31(7): 471-484.
19.	王立偉, 李躍杰, 王延群, 等. 耳聲導抗測試技術及在臨床中的應用. 國際生物醫學工程雜志, 2006, (1): 60-64.
20.	高勝利, 鄒宇, 羅仁忠, 等. 不同年齡嬰幼兒1000Hz和226Hz探測音聲導抗結果分析. 聽力學及言語疾病雜志, 2012, 20(4): 317-320.
21.	Son EJ, Park YA, Kim JH, et al. Classification of trace patterns of 226- and 1000-Hz tympanometry in healthy neonates. Auris Nasus Larynx, 2012, 39(5): 455-460.
22.	郭倩倩, 鄒彬, 姚紅兵. 寬頻聲導抗測試應用研究進展. 聽力學及言語疾病雜志, 2017, 25(3): 325-328.
23.	唐媛媛, 別旭, 孫秀珍, 等. 中耳含氣系統有限元數值建模. 中國耳鼻咽喉頭頸外科, 2021, 28(9): 573-576.
24.	Andreoli SM, Schlosser RJ, Wang LF, et al. Adenoid ciliostimulation in children with chronic otitis media. Otolaryngol Head Neck Surg, 2013, 148(1): 135-139.
25.	李衛紅, 葉京英, 魯辛辛. 腺樣體肥大兒童體液免疫水平的研究. 北京醫學, 2005, 27(8): 480-481.
26.	Kourelis K, Avgeri A, Kourelis T. Rising resonance frequency is the sole sign of early middle ear disease in children with adenoid hypertrophy. Otol Neurotol, 2021, 42(6): e724-e729.

1. 趙佳奇, 單麗華. 兒童腺樣體和扁桃體肥大治療理念新進展. 口腔醫學研究, 2021, 37(8): 693-695.
2. 劉燕, 魏萍, 寇巍, 等. 兒童腺樣體肥大與耳鼻咽喉科常見疾病關系的研究進展. 山東大學耳鼻喉眼學報, 2019, 33(4): 149-154.
3. 王夢航, 景紅, 郭紅光, 等. 鼻咽部數字化攝影及ETDQ-7量表評分對腺樣體肥大兒童的咽鼓管功能評價. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(1): 24-26.
4. Margolis RH, Saly GL, Keefe DH. Wideband reflectance tympanometry in normal adults. J Acoust Soc Am, 1999, 106(1): 265-280.
5. Iacovou E, Vlastarakos PV, Ferekidis E, et al. Multi-frequency tympanometry: clinical applications for the assessment of the middle ear status. Indian J Otolaryngol Head Neck Surg, 2013, 65(3): 283-287.
6. 徐繼峰, 蔣雯, 劉潔, 等. 寬頻聲導抗在中耳膽脂瘤與慢性化膿性中耳炎鑒別診斷中的價值. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(5): 376-381.
7. 劉潔, 蔣雯, 林歡, 等. 梅尼埃病患者寬頻聲導抗測試特點初步研究. 臨床耳鼻咽喉頭頸外科雜志, 2021, 35(12): 1068-1072.
8. 陳露靜, 蘭蘭, 黃鑫, 等. 耳硬化癥和中耳畸形患者的寬頻聲導抗研究. 中華耳科學雜志, 2020, 18(1): 57-62.
9. Utama MAS, Kentjono WA, Ekorini HE. Association between adenoid-nasopharyngeal ratio and tympanogram width in adenoid hypertrophy patients. Asian J Oncol, 2022, 8(1): 42-46.
10. 陳紅, 廉興, 張國忠, 等. CT和電子鼻內鏡診斷兒童腺樣體肥大的價值觀察. 中國CT和MRI雜志, 2021, 19(5): 144-146.
11. 蘇仁杰. 1000Hz探測音聲導抗及其鼓室圖分類方法的研究進展. 醫學綜述, 2012, 18(19): 3269-3273.
12. 傅德印. 主成分分析中的統計檢驗問題. 統計教育, 2007, 96(9): 4-7.
13. 方琴, 陶朵朵. 蘇州市中小學生腺樣體肥大及并發分泌性中耳炎分析. 中國學校衛生, 2021, 42(11): 1728-1731,1735.
14. 姜文君, 黃寧靜, 田成華. 單側人工耳蝸植入兒童寬頻聲導抗測試聲能吸收率特征研究. 聽力學及言語疾病雜志, 2021, 29(4): 369-372.
15. 盛海斌, 周嵌, 李海峰, 等. 低齡兒童分泌性中耳炎寬頻聲導抗特點及臨床意義. 中華耳鼻咽喉頭頸外科雜志, 2021, 56(6): 579-585.
16. 丁璐, 王晨露, 史文迪. 大前庭水管綜合征患者鼓膜吸收率特征初探. 中華耳科學雜志, 2021, 19(1): 16-20.
17. 虞曉芬, 傅玳. 多指標綜合評價方法綜述. 統計與決策, 2004, (11): 119-121.
18. Aithal V, Aithal S, Kei J, et al. Predictive accuracy of wideband absorbance at ambient and tympanometric peak pressure conditions in identifying children with surgically confirmed otitis media with effusion. J Am Acad Audiol, 2020, 31(7): 471-484.
19. 王立偉, 李躍杰, 王延群, 等. 耳聲導抗測試技術及在臨床中的應用. 國際生物醫學工程雜志, 2006, (1): 60-64.
20. 高勝利, 鄒宇, 羅仁忠, 等. 不同年齡嬰幼兒1000Hz和226Hz探測音聲導抗結果分析. 聽力學及言語疾病雜志, 2012, 20(4): 317-320.
21. Son EJ, Park YA, Kim JH, et al. Classification of trace patterns of 226- and 1000-Hz tympanometry in healthy neonates. Auris Nasus Larynx, 2012, 39(5): 455-460.
22. 郭倩倩, 鄒彬, 姚紅兵. 寬頻聲導抗測試應用研究進展. 聽力學及言語疾病雜志, 2017, 25(3): 325-328.
23. 唐媛媛, 別旭, 孫秀珍, 等. 中耳含氣系統有限元數值建模. 中國耳鼻咽喉頭頸外科, 2021, 28(9): 573-576.
24. Andreoli SM, Schlosser RJ, Wang LF, et al. Adenoid ciliostimulation in children with chronic otitis media. Otolaryngol Head Neck Surg, 2013, 148(1): 135-139.
25. 李衛紅, 葉京英, 魯辛辛. 腺樣體肥大兒童體液免疫水平的研究. 北京醫學, 2005, 27(8): 480-481.
26. Kourelis K, Avgeri A, Kourelis T. Rising resonance frequency is the sole sign of early middle ear disease in children with adenoid hypertrophy. Otol Neurotol, 2021, 42(6): e724-e729.

Chinese Journal of Evidence-Based Medicine

Preliminary study of the diagnostic value of wideband absorbance in adenoid hypertrophy children with type A tympanogram

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