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.	赵佳奇, 单丽华. 儿童腺样体和扁桃体肥大治疗理念新进展. 口腔医学研究, 2021, 37(8): 693-695.
2.	刘燕, 魏萍, 寇巍, 等. 儿童腺样体肥大与耳鼻咽喉科常见疾病关系的研究进展. 山东大学耳鼻喉眼学报, 2019, 33(4): 149-154.
3.	王梦航, 景红, 郭红光, 等. 鼻咽部数字化摄影及ETDQ-7量表评分对腺样体肥大儿童的咽鼓管功能评价. 临床耳鼻咽喉头颈外科杂志, 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.	徐继峰, 蒋雯, 刘洁, 等. 宽频声导抗在中耳胆脂瘤与慢性化脓性中耳炎鉴别诊断中的价值. 临床耳鼻咽喉头颈外科杂志, 2022, 36(5): 376-381.
7.	刘洁, 蒋雯, 林欢, 等. 梅尼埃病患者宽频声导抗测试特点初步研究. 临床耳鼻咽喉头颈外科杂志, 2021, 35(12): 1068-1072.
8.	陈露静, 兰兰, 黄鑫, 等. 耳硬化症和中耳畸形患者的宽频声导抗研究. 中华耳科学杂志, 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.	陈红, 廉兴, 张国忠, 等. CT和电子鼻内镜诊断儿童腺样体肥大的价值观察. 中国CT和MRI杂志, 2021, 19(5): 144-146.
11.	苏仁杰. 1000Hz探测音声导抗及其鼓室图分类方法的研究进展. 医学综述, 2012, 18(19): 3269-3273.
12.	傅德印. 主成分分析中的统计检验问题. 统计教育, 2007, 96(9): 4-7.
13.	方琴, 陶朵朵. 苏州市中小学生腺样体肥大及并发分泌性中耳炎分析. 中国学校卫生, 2021, 42(11): 1728-1731,1735.
14.	姜文君, 黄宁静, 田成华. 单侧人工耳蜗植入儿童宽频声导抗测试声能吸收率特征研究. 听力学及言语疾病杂志, 2021, 29(4): 369-372.
15.	盛海斌, 周嵌, 李海峰, 等. 低龄儿童分泌性中耳炎宽频声导抗特点及临床意义. 中华耳鼻咽喉头颈外科杂志, 2021, 56(6): 579-585.
16.	丁璐, 王晨露, 史文迪. 大前庭水管综合征患者鼓膜吸收率特征初探. 中华耳科学杂志, 2021, 19(1): 16-20.
17.	虞晓芬, 傅玳. 多指标综合评价方法综述. 统计与决策, 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.	王立伟, 李跃杰, 王延群, 等. 耳声导抗测试技术及在临床中的应用. 国际生物医学工程杂志, 2006, (1): 60-64.
20.	高胜利, 邹宇, 罗仁忠, 等. 不同年龄婴幼儿1000Hz和226Hz探测音声导抗结果分析. 听力学及言语疾病杂志, 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, 邹彬, 姚红兵. 宽频声导抗测试应用研究进展. 听力学及言语疾病杂志, 2017, 25(3): 325-328.
23.	唐媛媛, 别旭, 孙秀珍, 等. 中耳含气系统有限元数值建模. 中国耳鼻咽喉头颈外科, 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.	李卫红, 叶京英, 鲁辛辛. 腺样体肥大儿童体液免疫水平的研究. 北京医学, 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. 赵佳奇, 单丽华. 儿童腺样体和扁桃体肥大治疗理念新进展. 口腔医学研究, 2021, 37(8): 693-695.
2. 刘燕, 魏萍, 寇巍, 等. 儿童腺样体肥大与耳鼻咽喉科常见疾病关系的研究进展. 山东大学耳鼻喉眼学报, 2019, 33(4): 149-154.
3. 王梦航, 景红, 郭红光, 等. 鼻咽部数字化摄影及ETDQ-7量表评分对腺样体肥大儿童的咽鼓管功能评价. 临床耳鼻咽喉头颈外科杂志, 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. 徐继峰, 蒋雯, 刘洁, 等. 宽频声导抗在中耳胆脂瘤与慢性化脓性中耳炎鉴别诊断中的价值. 临床耳鼻咽喉头颈外科杂志, 2022, 36(5): 376-381.
7. 刘洁, 蒋雯, 林欢, 等. 梅尼埃病患者宽频声导抗测试特点初步研究. 临床耳鼻咽喉头颈外科杂志, 2021, 35(12): 1068-1072.
8. 陈露静, 兰兰, 黄鑫, 等. 耳硬化症和中耳畸形患者的宽频声导抗研究. 中华耳科学杂志, 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. 陈红, 廉兴, 张国忠, 等. CT和电子鼻内镜诊断儿童腺样体肥大的价值观察. 中国CT和MRI杂志, 2021, 19(5): 144-146.
11. 苏仁杰. 1000Hz探测音声导抗及其鼓室图分类方法的研究进展. 医学综述, 2012, 18(19): 3269-3273.
12. 傅德印. 主成分分析中的统计检验问题. 统计教育, 2007, 96(9): 4-7.
13. 方琴, 陶朵朵. 苏州市中小学生腺样体肥大及并发分泌性中耳炎分析. 中国学校卫生, 2021, 42(11): 1728-1731,1735.
14. 姜文君, 黄宁静, 田成华. 单侧人工耳蜗植入儿童宽频声导抗测试声能吸收率特征研究. 听力学及言语疾病杂志, 2021, 29(4): 369-372.
15. 盛海斌, 周嵌, 李海峰, 等. 低龄儿童分泌性中耳炎宽频声导抗特点及临床意义. 中华耳鼻咽喉头颈外科杂志, 2021, 56(6): 579-585.
16. 丁璐, 王晨露, 史文迪. 大前庭水管综合征患者鼓膜吸收率特征初探. 中华耳科学杂志, 2021, 19(1): 16-20.
17. 虞晓芬, 傅玳. 多指标综合评价方法综述. 统计与决策, 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. 王立伟, 李跃杰, 王延群, 等. 耳声导抗测试技术及在临床中的应用. 国际生物医学工程杂志, 2006, (1): 60-64.
20. 高胜利, 邹宇, 罗仁忠, 等. 不同年龄婴幼儿1000Hz和226Hz探测音声导抗结果分析. 听力学及言语疾病杂志, 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, 邹彬, 姚红兵. 宽频声导抗测试应用研究进展. 听力学及言语疾病杂志, 2017, 25(3): 325-328.
23. 唐媛媛, 别旭, 孙秀珍, 等. 中耳含气系统有限元数值建模. 中国耳鼻咽喉头颈外科, 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. 李卫红, 叶京英, 鲁辛辛. 腺样体肥大儿童体液免疫水平的研究. 北京医学, 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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