老年难治性分泌性中耳炎患者怀疑OMAAV的耳镜和听力线索
Otoscopic and Audiometric Clues for Suspecting OMAAV in Elderly Patients With Refractory Otitis Media With Effusion.
文献信息
| PMID | 42709593 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yutaro Oi |
| 作者单位 | Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama. |
| 期刊 | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估鼓膜表现和听力参数能否区分ANCA相关性血管炎性中耳炎（OMAAV）与难治性分泌性中耳炎（OME）。
研究设计： 回顾性队列研究。
地点： 三级转诊中心。
患者： 21例局限于耳部症状的OME型OMAAV患者和9例需要与OMAAV鉴别的难治性OME患者。
主要结局指标： 采用OMAAV鼓膜评分系统（SCOT）评估鼓膜表现。纯音测听采用三频率纯音平均值和频率特异性阈值。采用受试者工作特征（ROC）和logistic回归分析评估诊断效能。
结果： OME型OMAAV组的SCOT总分显著高于OME组（中位数，2 vs. 0；P<0.01），尤其是血管扩张和后壁肿胀。尽管三频率纯音平均值无显著差异，但频率特异性分析显示，OMAAV组在2000和8000 Hz的气导阈值以及250和500 Hz的骨导阈值显著升高。SCOT总分与500 Hz骨导阈值的联合显示出良好的诊断效能（曲线下面积，0.952），敏感性为100%，特异性为88.9%。
结论： 在老年难治性OME患者中，使用SCOT评分评估鼓膜表现并结合500 Hz骨导阈值，可能提供有用的耳科线索，促使进一步评估OMAAV，包括ANCA检测。
英文摘要
OBJECTIVE: To evaluate whether tympanic membrane findings and audiometric parameters can distinguish otitis media with ANCA-associated vasculitis (OMAAV) from refractory otitis media with effusion (OME).
STUDY DESIGN: Retrospective cohort study.
SETTING: Tertiary referral center.
PATIENTS: Twenty-one patients with OME-type OMAAV limited to otologic symptoms and 9 with refractory OME requiring differentiation from OMAAV.
MAIN OUTCOME MEASURES: Tympanic membrane findings were assessed using the scoring system of OMAAV tympanic membrane (SCOT). Pure-tone audiometry was performed using 3-frequency pure-tone averages and frequency-specific thresholds. Receiver operating characteristic (ROC) and logistic regression analyses evaluated diagnostic performance.
RESULTS: The total SCOT score was significantly higher in the OME-type OMAAV group than in the OME group (median, 2 vs. 0; P<0.01), particularly for vascular dilatation and posterior wall swelling. Although the 3-frequency pure-tone averages did not differ significantly, frequency-specific analysis revealed significantly elevated air conduction thresholds at 2000 and 8000 Hz and bone conduction thresholds at 250 and 500 Hz in the OMAAV group. The combination of the SCOT total score and the bone conduction threshold at 500 Hz showed promising diagnostic performance (area under the curve, 0.952), with a sensitivity of 100% and a specificity of 88.9%.
CONCLUSION: The combined assessment of tympanic membrane findings using the SCOT score and the bone conduction threshold at 500 Hz may provide useful otologic clues that prompt further evaluation for OMAAV, including ANCA testing, in elderly patients with refractory OME.