Daly Kathleen A, Hunter Lisa L, Lindgren Bruce R, Margolis Robert, Giebink G Scott
University of Minnesota Otitis Media Research Center, University of Minnesota School of Medicine, USA.
Arch Otolaryngol Head Neck Surg. 2003 May;129(5):517-22. doi: 10.1001/archotol.129.5.517.
To determine incidence and prevalence of middle ear sequelae and abnormal tympanometry results among children with chronic otitis media with effusion (OME) who received standard treatment with tympanostomy tubes.
Prospective cohort study.
Community clinic and academic medical center. Patients A total of 140 children followed up for 8 years after tube treatment.
Tympanic membrane perforation, atrophy, retraction, hearing loss, myringosclerosis, low static admittance (SA) and broad-peaked tympanogram, high SA and narrow-peaked tympanogram, and negative tympanometric peak pressure.
Annual incidence of sequelae was typically greater during 3 to 5 years than 6 to 8 years of follow-up. Greatest increases in incidence during the 5-year follow-up were for atrophy (67%), high SA and narrow-peaked tympanogram (70%), and retraction pocket (47%). Prevalence of these sequelae also increased over time, whereas low SA and broad-peaked tympanogram and negative tympanometric peak pressure decreased during follow-up. Sequela tended to become bilateral over time, and concordance of different sequelae in the same ear was low (kappa, 0.05-0.42).
Annual incidence of sequelae decreased during follow-up. This finding parallels decreasing incidence of OME and tube placement as children mature and demonstrates that sequelae are more likely to develop during active acute and chronic OME. The cumulative effect of incidence resulted in few ears free of sequelae by 8 years of follow-up. Based on this cohort of healthy children with OME, although the risk of sequelae decreased over time, functional and morphologic sequelae were prevalent and may put children at risk for continuing middle ear problems as they grow into adolescence and adulthood.
确定接受鼓膜置管标准治疗的慢性分泌性中耳炎（OME）患儿中耳后遗症的发病率和患病率以及鼓室图异常结果。
前瞻性队列研究。
社区诊所和学术医疗中心。患者：共140名儿童在置管治疗后随访8年。
鼓膜穿孔、萎缩、内陷、听力损失、鼓室硬化、静态声导纳（SA）低和鼓室图峰宽、SA高和鼓室图峰窄以及鼓室图峰压为负。
后遗症的年发病率在随访3至5年期间通常高于6至8年。5年随访期间发病率增加最多的是萎缩（67%）、SA高和鼓室图峰窄（70%）以及内陷袋（47%）。这些后遗症的患病率也随时间增加，而SA低和鼓室图峰宽以及鼓室图峰压为负在随访期间有所下降。后遗症往往随时间发展为双侧，同一耳中不同后遗症的一致性较低（kappa值，0.05 - 0.42）。
随访期间后遗症的年发病率下降。这一发现与随着儿童成熟OME和置管发生率下降相平行，表明后遗症更可能在急性和慢性OME活动期发生。发病率的累积效应导致在随访8年后几乎没有耳朵没有后遗症。基于这组患有OME的健康儿童，尽管后遗症风险随时间降低，但功能和形态学后遗症普遍存在，可能使儿童在成长为青少年和成年人时面临持续中耳问题的风险。
