Research The Diagnosis Of Wide Band Acoustic Absorbance In Children Otitis Media With Effusion

Objective:To analyze the wideband acoustic absorbance rate at each frequency by wide band immittance test for children with clinically diagnosed otitis media with effusion and healthy children.Compared with the conventional 226 Hz tympanometry,prospectively research the diagnostic value of wideband acoustic absorbance rate in children otitis media with effusion.Method:84 children diagnosed with otitis media with effusion in the first affiliated Hospital of Anhui Medical University and 30 healthy children were tested for wideband ascoustic absorbance rate and 226 Hz tympanometry by Danish Titan IMP440 wideband tympanometry.The testers included 84 children with recurrent otitis media undergoing tympanotomy.and 30 cases of healthy children without history of middle ear disease and hearing loss.Children with otitis media were divided into two groups according to the presence of middle ear effusion during the surgery.Group A: 50 children with middle ear effusion during surgery(77ears,age :20 months to 122 months).Group B: 34 children without middle ear effusion during surgery(53 ears,age:22 month to 116months).Group C :30 healthy children(60 ears,aged from 22 months to 120months).Statistical analyzed the absorbance rate at each frequency for each group to find out whether the absorbance rate is different in each group.The diagnostic value of wideband acoustic absorbance was analyzed by AUROC(area under the receiver operating characteristic curve),and the frequency range of the best diagnostic value was determined.Compared the diagnostic sensitivity and specificity of wideband acoustic absorbance with 226 Hz tympanometry,and evaluated the advantages and disadvantages of wideband acoustic absorbance.Results:Analyzed the average absorbance rate of three groups used nonparametric tests.In the range of 0.25 to 4 k Hz.The difference of the mean absorbance rate among the three groups was statistically significant(P<0.05).But at 8k Hz,there was no significant difference in absorbance among the three groups(P > 0.05).And in the rangeof 0.5 to 2 k Hz,the average mean absorbance rate of middle ear effusion group was significantly lower than that of no effusion group and control group,and the difference was statistically significant(P<0.05).The average mean absorbance rate of the non-effusion group was also significantly lower than that of the control group in the range of 0.5?1k Hz(P<0.05).After analyzed the ROC curve,the results show that the diagnostic value of the average mean absorbance rate in the range of 0.5 to 2 k Hz is the highest(AUROC:0.984).Followed by 1k Hz and 1.5 k Hz(AUROC:0.973 and 0.967,respectively).In the range of 0.5?2 k Hz,the sensitivity(100%)and specificity(94%)of acoustic absorbance in the diagnosis of middle ear effusion were higher than those of226 Hz tympanometry(sensitivity: 88.3%,specificity: 84.9%).Conclusion:Wideband acoustic absorbance has a high diagnostic value for children otitis media with effusion.In addition,it has the advantages of objectivity,noninvasive,fast.Compared with conventional 226 Hz tympanometry,wideband acoustic absorbance has higher sensitivity and specificity in the diagnosis of children otitis media with effusion.wideband acoustic absorbance equipment exhibits a good prospect of diagnosing exudative lesions of middle ear as a new type of tool for measuring the mechanical acoustic characteristics of the middle ear,and has a high research value.