Umapathy N, Dekker P J
Department of Otolaryngology, City Hospital, Birmingham, England.
Arch Otolaryngol Head Neck Surg. 2003 Oct;129(10):1053-5. doi: 10.1001/archotol.129.10.1053.
To evaluate the results of myringoplasty in children 4 to 14 years old at the time of surgery.
Retrospective analysis of case notes for 100 consecutive children who had myringoplasty in a teaching hospital serving as a primary care and referral center.
Between March 1994 and March 1999, patients 14 years or younger at the time of surgery were identified by the computer database. There were 118 procedures performed in 100 patients (18 had a second procedure performed in the contralateral ear at a later date). Twenty-three patients were excluded because they underwent concurrent mastoid exploration, and 6 others because of inadequate follow-up, leaving 89 cases for analysis. Data from revision procedures were not included.
Graft success was defined as an intact eardrum at 12 months postoperatively and middle ear effusion signaled graft failure. Success in terms of hearing was defined as an improvement in perception of pure-tone thresholds of 10 dB or greater over 2 consecutive frequencies compared with the results of the preoperative audiogram.
Closure of perforation was achieved in 90% (80) of patients, but dropped to 88% (78) as 2 patients developed glue ear. Hearing improved in 64 patients (72%), deteriorated in 7 (8%), and remained unchanged in 18 (20%). There was no case of profound hearing loss.
The success rate of myringoplasty in children is comparable to that reported for adults. The incidence of middle ear effusion in grafted ears is not higher than that reported for nongrafted ears, and children who have had myringoplasty can be treated as safely with ventilation tubes as any other children.
评估4至14岁儿童鼓膜成形术的手术效果。
对一家作为初级保健和转诊中心的教学医院中连续100例接受鼓膜成形术的儿童病历进行回顾性分析。
通过计算机数据库识别1994年3月至1999年3月期间手术时年龄在14岁及以下的患者。100例患者共进行了118次手术（18例在对侧耳后期进行了第二次手术）。23例患者因同时进行了乳突探查而被排除，6例因随访不充分被排除，剩余89例用于分析。翻修手术的数据未纳入。
移植物成功定义为术后12个月鼓膜完整，中耳积液表明移植物失败。听力成功定义为与术前听力图结果相比，连续两个频率的纯音阈值感知改善10dB或更多。
90%（80例）患者的穿孔得以闭合，但由于2例患者出现胶耳，闭合率降至88%（78例）。64例患者（72%）听力改善，7例（8%）听力恶化，18例（20%）听力不变。无深度听力损失病例。
儿童鼓膜成形术的成功率与成人报道的相当。移植耳中耳积液的发生率不高于未移植耳，接受鼓膜成形术的儿童使用通气管治疗与其他儿童一样安全。
