咽鼓管测压法的R值对咽鼓管异常开放诊断效能的研究

Research on the diagnostic efficiency of the “R” value of tubomanometry in detecting patulous eustachian tube

伏振豪;周兢程;贾建平;王方园;赵丹珩;刘娅;张浩泽;郭蒙园;朱荔;侯琨;丁雨麟;李晓龙;侯昭晖

1:中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部听觉与平衡觉全国重点实验室国家耳鼻咽喉疾病临床医学研究中心聋病教育部重点实验室聋病防治北京市重点实验室

2:中国人民解放军医学院

摘要
目的 评估咽鼓管测压法(tubomanometry, TMM)中R值对咽鼓管异常开放(patulous eustachian tube, PET)的诊断效能。方法 回顾性分析58例PET患者和65例正常对照组的临床资料,分别在30、40、50 mbar鼻咽部压力下对两组进行TMM检测,通过受试者工作特征(receiver operating characteristic, ROC)曲线,评估R值对PET的诊断效能。结果 对照组在30、40、50 mbar鼻咽部压力下的R平均值分别为0.86±0.50、0.76±0.41、0.68±0.34;而PET组对应的R值则显著较低,分别为0.56±0.38、0.50±0.36、0.46±0.38。ROC曲线分析示,这些压力下的曲线下面积(area under the curve, AUC)分别为0.69、0.74、0.74。在30、40、50 mbar鼻咽部压力下R值诊断PET的特异度和灵敏度分别为76.90%和54.30%、74.60%和68.10%、86.90%和54.30%。在30、40、50 mbar鼻咽部压力下,对照组和PET组R>1的发生率分别为29.23%(38/130)和12.77%(12/94)(χ~2=8.69,P=0.003),20.00%(26/130)和6.38%(6/94)(χ~2=7.20,P=0.007),10.00%(13/130)和3.19%(3/94)(χ~2=2.87,P=0.09)。结论 尽管TMM的低R值可一定程度上反映PET,但作为PET独立的诊断标准无足够的灵敏度和特异度。
关键词
咽鼓管测压法;R值;咽鼓管异常开放;诊断效能;受试者工作特征曲线
基金项目(Foundation):
国家耳鼻咽喉疾病临床医学研究中心资助,国家重点研发计划(2023YFC2508405)
作者
伏振豪;周兢程;贾建平;王方园;赵丹珩;刘娅;张浩泽;郭蒙园;朱荔;侯琨;丁雨麟;李晓龙;侯昭晖
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