Karevold Gunnhild, Haapkylä Johanna, Pitkäranta Anne, Kvaerner Kari Jorunn
Faculty Division of Akershus University Hospital, University of Oslo, Oslo, Norway.
Int J Pediatr Otorhinolaryngol. 2007 Jul;71(7):1035-9. doi: 10.1016/j.ijporl.2007.03.010. Epub 2007 May 4.
Bi-national comparison of surgical treatment for paediatric otitis media.
Registry based cross-sectional study with complete data on surgery for otitis media in 2002; 21,811 Finnish and Norwegian children aged 0-16 years.
Total rates for otitis media surgery were 82.5 and 146.5 per 10,000 children in Norway and Finland, respectively. Adenoidectomies were four times more frequently performed in Finland and rates for tympanostomy tube insertions differed 2-3-fold, Finland having the higher rate. The contrast in surgery rates was most striking in the age group 0-2 years. Further, the more sparsely populated regions had significantly higher overall surgery rates.
The large variability in the incidence of otitis media surgery between two similar countries questions whether present guidelines ensure equal treatment in similarly affected children and pinpoints the difficulty in giving advice on age, time and type of surgery.
对小儿中耳炎外科治疗进行双边比较。
基于登记处的横断面研究，收集了2002年中耳炎手术的完整数据；21811名0至16岁的芬兰和挪威儿童。
挪威和芬兰每10000名儿童中中耳炎手术的总发生率分别为82.5和146.5。芬兰腺样体切除术的实施频率是挪威的四倍，鼓膜置管术的发生率相差2至3倍，芬兰的发生率更高。手术率的差异在0至2岁年龄组最为显著。此外，人口密度较低的地区总体手术率明显更高。
两个相似国家之间中耳炎手术发生率的巨大差异使人质疑当前指南是否能确保对病情相似的儿童进行平等治疗，并突出了在手术年龄、时间和类型方面提供建议的困难。
