环境压力鼓室压图检测主观搏动性耳鸣影像学相关表现的筛查效用
Screening Utility of Ambient Pressure Tympanometry for the Detection of Radiologic Correlates of Subjective Pulsatile Tinnitus.
文献信息
| PMID | 42788144 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Christian Bernard |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, FL. |
| 期刊 | Otology & neurotology open |
| SCI 分区 | Q3 |
| IF | 1.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 确定环境压力鼓室压图（APT）检测主观搏动性耳鸣（PT）影像学相关表现的敏感性和特异性。
研究设计： 回顾性综述。
地点： 三级诊疗诊所。
患者： 2021年至2025年间接受APT的107名PT成人（147耳）。
干预： 盲法听力学家将APT曲线分类为脉搏同步或非脉搏同步。
主要结局指标： 以任何影像学诊断或外科医生定义的诊断作为2个独立金标准，计算APT的敏感性和特异性。
结果： 在137耳（93.2%）接受影像学检查的耳中，63耳（46%）具有脉搏同步APT模式。51耳（37.2%）有影像学相关表现，65耳（44.2%）获得外科医生诊断。对于影像学相关表现，APT的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为51%、57%、41.3%和66.2%；对于外科医生诊断，分别为43.1%、54.9%、43.1%和54.9%。在以PT为主诉的86名患者（116耳）亚组中，对于影像学相关表现，APT的敏感性、特异性、PPV和NPV分别为56.9%、54.2%、46%和55.2%；对于外科医生诊断，分别为43.6%、54.1%、46.2%和51.6%。
结论： 由于敏感性和特异性较低，APT可能不是检测主观PT影像学相关表现的可靠筛查工具。尽管APT阴性，临床医生仍应继续对PT进行影像学评估，并就影像学的局限性以及检测主观PT来源可能需要多种模式向患者提供咨询。
英文摘要
OBJECTIVE: To determine the sensitivity and specificity of ambient pressure tympanometry (APT) for the detection of a radiologic correlate of subjective pulsatile tinnitus (PT).
STUDY DESIGN: Retrospective review.
SETTING: Tertiary care clinic.
PATIENTS: 107 adults (147 ears) with PT who underwent APT between 2021 and 2025.
INTERVENTIONS: Blinded audiologists classified APT tracings as pulse-synchronous or not.
MAIN OUTCOME MEASURES: Sensitivity and specificity of APT using any radiologic diagnosis or surgeon-defined diagnosis as 2 separate gold standards.
RESULTS: Of 137 (93.2%) ears that underwent imaging, 63 (46%) had a pulse-synchronous APT pattern. Fifty-one (37.2%) had a radiologic correlate, and 65 (44.2%) were given a surgeon diagnosis. Respectively, APT sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 51%, 57%, 41.3%, and 66.2% for a radiologic correlate and were 43.1%, 54.9%, 43.1%, and 54.9% for a surgeon diagnosis. In a subgroup of 86 patients (116 ears) with a chief complaint of PT, APT sensitivity, specificity, PPV, and NPV for a radiologic correlate were 56.9%, 54.2%, 46%, and 55.2%, and for a surgeon diagnosis were 43.6%, 54.1%, 46.2%, and 51.6%.
CONCLUSION: With a low sensitivity and specificity, APT may not be a reliable screening tool for the detection of a radiologic correlate of subjective PT. Clinicians should continue to pursue radiologic evaluation of PT despite a negative APT and counsel patients on the limits of imaging and the potential need for multiple modalities for the detection of subjective PT sources.