Ullrich D, Kreutzer S
HNO-Praxis.
Laryngorhinootologie. 2006 Jul;85(7):501-5. doi: 10.1055/s-2006-925206. Epub 2006 Apr 10.
The insertion of tympanostomy tubes is the most common surgical procedure in the world. A major complication of chronic intubation is infectious otorrhea. The present study compares the rate of infectious otorrhea and survival rate of gold-plated silver tubes (GPR) vs. Silver Oxide-Impregnated Silastic Tubes (SPR).
The prospective, randomized clincial trial was conducted with 116 children (59 female, 57 male) aged between 16 and 127 months (median: 51 months). Bilateral insertion of ventilation tubes was performed with SPR on one side and GPR on the other side in all children. The resulting data were compared using 2-tailed Wilcoxon-test.
Out of 116 children, 11 left the study, 26 children finished the study by extrusion of both tubes, 32 children lost one tube and 47 children lost no tube. Total follow-up of GPR and SPR amounted to 703 and 949 months, respectively. Mean survival rate of SPR and GPR was 9.9 +/- 4.6 and 7.0 +/- 3.4 months, respectively (p < 0.001). During the first postoperative week, 13% of children suffered from otorrhea; after the first postoperative week until extrusion of the tubes, otorrhea was observed in 55% of children. The ratio otorrhea/months amounted to 0.046 and 0.05 in SPR and GPR, respectively (p: n. s.).
Survival rate of SPR is significantly longer than compared to GPR. No differences in the otorrhea rate of SPR vs. GPR are detectable. The longer survival rate of SPR seems to be independent of the rate of infectious otorrhea but depends probably on other effects of biocompatibility.
鼓膜置管术是世界上最常见的外科手术。慢性置管的一个主要并发症是感染性耳漏。本研究比较了镀金银管(GPR)与含氧化银硅橡胶管(SPR)的感染性耳漏发生率和存活率。
对116名年龄在16至127个月(中位数:51个月)的儿童(59名女性,57名男性)进行了前瞻性随机临床试验。所有儿童均在一侧插入SPR通气管,另一侧插入GPR通气管。使用双尾Wilcoxon检验对所得数据进行比较。
116名儿童中,11名退出研究,26名儿童因两根管子均脱出而完成研究,32名儿童丢失一根管子,47名儿童未丢失管子。GPR和SPR的总随访时间分别为703个月和949个月。SPR和GPR的平均存活率分别为9.9±4.6个月和7.0±3.4个月(p<0.001)。术后第一周,13%的儿童出现耳漏;术后第一周后至管子脱出,55%的儿童出现耳漏。SPR和GPR的耳漏/月比率分别为0.046和0.05(p:无显著性差异)。
SPR的存活率明显长于GPR。未检测到SPR与GPR在耳漏发生率上的差异。SPR较长的存活率似乎与感染性耳漏发生率无关,但可能取决于生物相容性的其他影响。