Siegel Gordon J, Chandra Rakesh K
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Medical School, Il 60611, USA.
Otolaryngol Head Neck Surg. 2002 Jul;127(1):60-6. doi: 10.1067/mhn.2002.126475.
Myringotomy with insertion of pressure equalization tubes has proven to be extremely effective in treating persistent serous otitis media (SOM). This study compares the advantages and disadvantages of this procedure when performed in the operating room or with a laser in an office setting.
Patients selected either traditional myringotomy and tube (M & T; n = 29) done in an operating room under general anesthesia or Laser Office Ventilation of Ears with Insertion of Tubes (LOVE IT; n = 35) done in an office setting with only topical anesthesia. The reasons for selecting either M&T or LOVE IT and satisfaction with the procedure chosen were evaluated by survey, the results of which were compared statistically. Chart review was performed to determine the time and cost of the procedures, time interval from diagnosis to treatment, tube longevity, and complications.
Overall satisfaction was similar with both procedures. Patients and families were more likely to choose LOVE IT based on the anesthetic technique involved (P < 0.001, chi(2)). M&T required less time to perform, whereas the cost of LOVE IT was less. Tube longevity and complication rates were similar between the two procedures, and all complications were minor.
LOVE IT is a potential alternative to traditional M&T in the treatment of SOM. LOVE IT is most likely to be selected by patients/parents who wish to avoid a general anesthetic and provides a level of satisfaction similar to that of traditional M&T.
鼓膜切开术并插入压力平衡管已被证明在治疗持续性浆液性中耳炎(SOM)方面极为有效。本研究比较了在手术室进行该手术与在门诊环境中使用激光进行该手术的优缺点。
患者选择在手术室全身麻醉下进行传统鼓膜切开术并置管(M&T;n = 29),或在门诊仅使用局部麻醉进行激光耳部通气并置管(LOVE IT;n = 35)。通过调查评估选择M&T或LOVE IT的原因以及对所选手术的满意度,并对结果进行统计学比较。进行病历审查以确定手术的时间和费用、从诊断到治疗的时间间隔、置管寿命以及并发症。
两种手术的总体满意度相似。基于所涉及的麻醉技术,患者及其家属更倾向于选择LOVE IT(P < 0.001,卡方检验)。M&T手术所需时间较短,而LOVE IT的费用较低。两种手术的置管寿命和并发症发生率相似,且所有并发症均为轻微并发症。
在治疗SOM方面,LOVE IT是传统M&T的一种潜在替代方法。希望避免全身麻醉的患者/家长最有可能选择LOVE IT,其满意度与传统M&T相似。