背景和目的：急性化膿性中耳炎是兒童人口當中常見的流行疾病，以往文獻當中曾記載使用"頻譜梯度聲納迴波測量"來評估罹患積液性中耳炎兒童中耳內部滲出物的存在與否，但並未有評估中耳炎各分期之聽力篩檢文獻報告。方法：本研究利用前瞻性、連續性的方法取樣來評估\"頻譜梯度聲納迴波測量"在篩檢不同分期急性化膿性中耳炎導致之聽力障礙所具有之儀器準確度；研究對象總共79 人(333 耳)，其中男性52 (65.8%)名，女性26 (34.2%) 名，平均年齡約4.5 ± 2.7 歲。結果：研究發現在中耳炎之各分期中敏感度介於35-48%間、特異度介於79%~90%間、陽性預測值介於50%~85%間，而陰性預測值介於42-59%間；其ROC 曲線(receiver operating characteristic curve) 下最大面積均未超過0.8，而其正確率在化膿期最高也只有67%。結論： "頻譜梯度聲納迴波測量"的特異度尚可，或許可用來排除沒有罹病的兒童，但儀器仍不能取代正確的耳鏡理學檢查。

Background and Purpose: As an important public health issue, acute suppurative otitismedia is a prevalent disease in pediatric populations. Spectral gradient acoustic reflectometryanalyzes the frequency spectrum of sound waves to generate a spectral gradient angle thatcorresponds to the probability of middle ear effusion. However, its diagnostic application to acutesuppurative otitis media at different stages has not been studied. Methods: We used aprospective study design to obtain instrument validation data for spectral gradient acousticreflectometry. We obtained data from 79 patients (133 ears), among which 52 (65.8%) were boysand 26 (34.2%) were girls. The mean age was 4.5 ± 2.7 years. Results: We found that itssensitivity ranged 35%~48%, its specificity ranged 79%~90%, its positive predictive value ranged50%~85%, and its negative predictive value ranged 42%~59%; the largest areas under the receiveroperating characteristic (ROC) curve did not exceed 0.8, and the highest accuracy for spectralgradient acoustic reflectometry of 67% was observed in the suppurative stage. Conclusion: Weconcluded that the reasonable specificity of spectral gradient acoustic reflectometry indicates thatthis instrument might be able to exclude healthy subjects among pediatric patients, but it cannotreplace pneumatic otoscopy.