背景:改良的九步测试是评估咽鼓管功能的经典方法。然而,在改良的九步试验中,中耳压力最大差值(mdMEP)增加的临床解释尚不清楚.我们假设乳突腔的不同储层效应会使修改后的九步测试结果产生偏差。
方法:对108名连续参与者(216耳)进行回顾性筛查。其中,符合纳入/排除标准的55名参与者(82耳)入组。乳突腔的体积结果,修改后的九步测试的参数(mdMEP,中耳压力,鼓膜顺应性),和人口统计数据进行了分析。
结果:发现mdMEP与乳突腔容积之间呈显著负相关(R=.467,p<.001)。mdMEP>70daPa的耳朵在乳突腔中显示出不良的气化,体积小于3000mm3(分析的所有耳朵的第10百分位数)。乳突腔体积低于第25百分位数的耳朵显示mdMEP明显较高(p<.001)。乳突腔体积高于第75百分位数的患者明显年轻(p<.001)。mdMEP的多元回归分析显示,使用包括中耳压力在内的因素进行了良好的拟合(R=.854),导纳和,最重要的是,乳突体积的倒数(β=0.752,p<.001)。
结论:mdMEP,修改后的九步测试的主要参数,与乳突腔容积呈负相关。因此,修改后的九步试验结果应考虑乳突腔容积来解释.
BACKGROUND: The modified nine-step test is a classical method for evaluating Eustachian tube function. However, clinical interpretation of the increased maximal difference in middle ear pressure (mdMEP) in the modified nine-step test is unknown. We hypothesised that the different reservoir effects of the
mastoid cavity can bias the results of the modified nine-step test.
METHODS: A total of 108 consecutive participants (216 ears) were retrospectively screened. Of these, 55 participants (82 ears) who met the inclusion/exclusion criteria were enrolled. The volumetric results of the
mastoid cavity, parameters of the modified nine-step test (mdMEP, middle ear pressure, tympanic membrane compliance), and demographic data were analysed.
RESULTS: A significant negative correlation was found between mdMEP and mastoid cavity volume (R = .467, p < .001). Ears with mdMEP >70 daPa showed poor pneumatization in the
mastoid cavity, with volumes less than 3000 mm3 (10th percentile of all ears analysed). Ears with
mastoid cavity volumes lower than the 25th percentile showed a significantly higher mdMEP (p < .001). Patients with
mastoid cavity volumes higher than the 75th percentile were significantly younger (p < .001). Multivariate regression analysis for mdMEP showed a good fit (R = .854) using factors including middle ear pressure, admittance and, most importantly, the reciprocal of mastoid volume (Beta = 0.752, p < .001).
CONCLUSIONS: The mdMEP, the main parameter of the modified nine-step test, was negatively correlated with the mastoid cavity volume. Therefore, the results of the modified nine-step test should be interpreted with consideration of mastoid cavity volume.