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鼓膜穿刺置管术能否替代鼓膜切开术?

Could radiofrequency myringotomy be an alternative to incisional myringotomy?

作者信息

Cinar Fikret, Ugur M Birol, Uzun Lokman

机构信息

Zonguldak Karaelmas University, Faculty of Medicine, Department of Otolaryngology-Head and Neck Surgery, Esenkoy Yerleskesi/Kozlu, 67600 Zonguldak, Turkey.

出版信息

Int J Pediatr Otorhinolaryngol. 2008 Oct;72(10):1493-6. doi: 10.1016/j.ijporl.2008.06.020. Epub 2008 Aug 9.

Abstract

OBJECTIVE

To evaluate the usefulness of radiofrequency myringotomy (RFM) and the closure time of the myringotomy site in comparison to incisional myringotomy (IM).

METHODS

We performed conventional surgical myringotomy on the right ears and RFM on the left ears of 40 rabbits. In order to investigate the effect of the power of energy delivered on the patency period we arranged the animals into two groups: three power grade in RFM group 1 (RFMg1; n: 20) and six power grade in RFM group 2 (RFMg2; n: 20). The follow-up of the myringotomy procedure was performed on days 5, 8, 11, 14 and 17 with examination under the operating microscope.

RESULTS

At the first examination on day 5 after the procedure, all IM openings were found to be closed while seven and eight (36 and 44%) of the tympanic membranes in the radiofrequency groups 1 and 2 remained open, respectively. In these remaining ears, RFM site was patent up to days 11 and 14, respectively in the two RFM groups. None of the RFMs was patent on study day 17. The difference between the closure time of myringotomy sites of the radiofrequency and IM groups was statistically significant (p < 0.05). In comparison of the two RFM groups, we found approximately equal rates regarding the myringotomy patency (p > 005; chi2 yates: 0.02). The complication rates were 5 and 2% for the IM and RFM groups, respectively.

CONCLUSIONS

Radiofrequency myringotomies last longer than incisional myringotomies. With the low complication rate, it is possible to perform this bloodless RF procedure in an office setting. Increased power grade of radiofrequency has no effect on prolonging the myringotomy patency. RFM appears to be a safe and simple procedure that can be used as an alternative to IM.

摘要

目的

评估与切开鼓膜造孔术(IM)相比,射频鼓膜造孔术(RFM)的有效性及鼓膜造孔部位的闭合时间。

方法

我们对40只兔子的右耳进行传统外科鼓膜造孔术,左耳进行RFM。为研究传递能量的功率对通畅期的影响,我们将动物分为两组:RFM第1组(RFMg1;n = 20)有三个功率等级,RFM第2组(RFMg2;n = 20)有六个功率等级。在术后第5、8、11、14和17天,在手术显微镜下检查对鼓膜造孔术进行随访。

结果

在术后第5天的首次检查中,发现所有IM开口均已闭合,而RFM第1组和第2组分别有7个和8个(36%和44%)鼓膜仍保持开放。在这些剩余的耳朵中,两个RFM组的RFM部位分别在第11天和第14天仍保持通畅。在研究第17天,所有RFM均未保持通畅。射频组和IM组鼓膜造孔部位闭合时间的差异具有统计学意义(p < 0.05)。比较两个RFM组,我们发现鼓膜造孔通畅率大致相当(p > 0.05;Yates卡方检验:0.02)。IM组和RFM组的并发症发生率分别为5%和2%。

结论

射频鼓膜造孔术的持续时间比切开鼓膜造孔术长。由于并发症发生率低,在门诊环境中进行这种无血的射频手术是可行的。增加射频功率等级对延长鼓膜造孔通畅时间没有影响。RFM似乎是一种安全、简单的手术,可作为IM的替代方法。

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