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中耳积液患儿鼓膜置管后遗症:一项为期三年的随访研究。

Tympanostomy tube sequelae in children with otitis media with effusion: a three-year follow-up study.

作者信息

Pereira Maria Beatriz Rotta, Pereira Denise Rotta Ruttkay, Costa Sady Selaimen da

机构信息

Federal University of Rio Grande do Sul.

出版信息

Braz J Otorhinolaryngol. 2005 Jul-Aug;71(4):415-20. doi: 10.1016/s1808-8694(15)31192-7. Epub 2005 Dec 15.

Abstract

UNLABELLED

Tympanostomy tube (TT) insertion is one of the most frequently performed procedures in otolaryngology. Otorrhea, tympanosclerosis, retraction, perforation, and cholesteatoma are complications reported in the literature after its application.

AIM

To determine the incidence and the type of TT insertion sequelae/complications in children presenting with recurrent otitis media and chronic otitis media with effusion undergoing myringotomy and tube placement.

STUDY DESIGN

Prospective cohort study.

MATERIAL AND METHOD

A total of 75 children (150 ears) aged 11 months to 10 years were regularly followed up for up to 38 months after TT insertion.

RESULTS

Incidence of sequelae/complications: otorrhea--47.3% of the ears; perforation--2.1%; retractions--39.7%; tympanosclerosis--23.3%. Average length of stay: 12.13 months. Mean age at initial tube placement of children not requiring a second set of tubes = 35.9 months and mean age at initial tube insertion of children requiring an additional set of tubes = 25.6 months (P = 0.04). TT stayed longer in the ears that had more episodes of otorrhea (P = 0.01). TT insertion with adenoidectomy was associated with a smaller number of otorrhea episodes (P = 0.02)

CONCLUSIONS

Otorrhea was the most frequently found complication. TT placement with adenoidectomy was associated with fewer otorrhea episodes. TT extruded later in those ears that had more episodes of otorrhea. Younger age at the time of the initial tube placement is associated with higher incidence of additional tube placement. One in six patients will probably require a second set of ventilation tubes.

摘要

未标注

鼓膜置管(TT)插入术是耳鼻喉科最常开展的手术之一。文献报道该手术后会出现耳漏、鼓室硬化、内陷、穿孔和胆脂瘤等并发症。

目的

确定在接受鼓膜切开置管术的复发性中耳炎和慢性渗出性中耳炎患儿中,TT插入术后后遗症/并发症的发生率及类型。

研究设计

前瞻性队列研究。

材料与方法

共75名年龄在11个月至10岁的儿童(150只耳朵)在TT插入术后接受了长达38个月的定期随访。

结果

后遗症/并发症的发生率:耳漏——47.3%的耳朵;穿孔——2.1%;内陷——39.7%;鼓室硬化——23.3%。平均住院时间:12.13个月。不需要第二套置管的儿童初次置管时的平均年龄 = 35.9个月,需要额外一套置管的儿童初次置管时的平均年龄 = 25.6个月(P = 0.04)。耳漏发作次数较多的耳朵中TT留置时间更长(P = 0.01)。TT插入术联合腺样体切除术与较少的耳漏发作次数相关(P = 0.02)

结论

耳漏是最常见的并发症。TT插入术联合腺样体切除术与较少的耳漏发作次数相关。耳漏发作次数较多的耳朵中TT挤出时间较晚。初次置管时年龄较小与额外置管的发生率较高相关。六分之一的患者可能需要第二套通气管。

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本文引用的文献

1
A new treatment for chronic secretory otitis media.慢性分泌性中耳炎的一种新疗法。
AMA Arch Otolaryngol. 1954 Jun;59(6):653-4. doi: 10.1001/archotol.1954.00710050665001.
3
8
Meta-analysis of tympanostomy tube sequelae.鼓膜置管后遗症的荟萃分析。
Otolaryngol Head Neck Surg. 2001 Apr;124(4):374-80. doi: 10.1067/mhn.2001.113941.

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