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儿童鼓膜成形术:与成人的比较

[Myringoplasty in children: a comparison with an adult population].

作者信息

Albera R, Milan F, Riontino E, Giordano L, Gervasio C F, Bussi M, Lacilla M, Ferrero V

机构信息

Dipartimento di Fisiopatologia Clinica, II, Università di Torino.

出版信息

Acta Otorhinolaryngol Ital. 1998 Oct;18(5):295-9.

Abstract

The indications for myringoplasty in children has always been a controversial subject since many authors feel the high frequency of the phlogistic auricular processes in children constitute an unfavorable prognostic factor to success of the procedure. The authors present the results obtained in 23 patients under 17 years of age who had undergone myringoplasty for simple perforation of the tympanum. In cases of posterior and inferior perforations, surgery was performed using the underlay technique and a transmeatal approach; in all other cases the overlay technique was used with a retroauricular approach. An average 30 month follow-up (range 12-55 months) revealed new perforations in only 2 cases (9%). From the functional point of view the average air/bone conduction gap was reduced to 10 dB. As a control, the results were compared to those obtained in 150 patients over 16 years of age, again affected by simple perforation of the tympanic membrane and treated by myringoplasty using the same methods. In the adults, 22 new perforations were found (15%) while the functional results were analogous to those obtained in the children group. In this light, it can be asserted that myringoplasty can be considered a safe procedure to be used in children and it does not appear essential to wait until they have finished growing before performing this procedure.

摘要

儿童鼓膜成形术的适应证一直是一个有争议的话题,因为许多作者认为儿童耳部炎症性病变的高发生率是该手术成功的一个不利预后因素。作者介绍了23例17岁以下因鼓膜单纯穿孔接受鼓膜成形术患者的治疗结果。对于后下方穿孔的病例,采用内植法和经耳道入路进行手术;在所有其他病例中,采用外植法和耳后入路。平均30个月的随访(范围12 - 55个月)显示,仅2例(9%)出现新的穿孔。从功能角度来看,平均气骨导差缩小至10 dB。作为对照,将结果与150例16岁以上同样因鼓膜单纯穿孔并采用相同方法进行鼓膜成形术治疗的患者的结果进行比较。在成人中,发现22例新穿孔(15%),而功能结果与儿童组相似。据此可以断言,鼓膜成形术可被视为一种用于儿童的安全手术,而且在儿童完成生长发育之前进行该手术似乎并非必要。

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