Barañano Christopher F, Sweitzer Richard S, Mahalak Mandy Lutz, Alexander Nathan S, Woolley Audie L
Pediatric ENT Associates, 1940 Elmer Bissell Rd, Birmingham, AL 35243, USA.
Arch Otolaryngol Head Neck Surg. 2010 Jun;136(6):557-60. doi: 10.1001/archoto.2010.80.
To investigate the impact of myringotomy tubes (MTs) on outcomes for pediatric cochlear implant (CI) recipients.
Retrospective case-control chart review.
Tertiary care pediatric hospital.
Sixty-two patients received an MT before CI (mean [SD] age at initial CI, 3.20 [2.45] years). Seventy-eight ears received CIs and MTs.
The MTs were removed and allowed to extrude before CI (59% [n = 46]) or kept in place until CI (41% [n = 32]).
Otorrhea, persistent tympanic membrane (TM) perforation, and need for additional procedures were recorded. Statistical analysis was performed with the Fisher exact test.
Forty ears (51%) required more than 1 set of MTs. Ten ears (22%) in which the MTs were removed before CI required a separate MT after CI compared with 6 ears (19%) in which the MTs remained in place until CI (P = .78). The MTs that were present during CI were either removed with myringoplasty (31% [n = 10]) or retained after surgery (69% [n = 22]). All TMs in which the tubes were removed before or during CI healed. There were 3 persistent TM perforations that required surgical treatment. There were no cases of meningitis and no removals of CIs because of infection.
Myringotomy tubes do not appear to adversely affect the final outcomes of pediatric CI recipients and can be managed similarly to MTs in other otitis media-prone children. They may be left in place in children who continue to experience recurrent acute otitis media or removed in children who no longer need them.
探讨鼓膜切开置管（MTs）对小儿人工耳蜗（CI）植入受者结局的影响。
回顾性病例对照图表审查。
三级护理儿科医院。
62例患者在CI植入前接受了MTs（初次CI植入时的平均[标准差]年龄为3.20[2.45]岁）。78只耳朵接受了CI植入和MTs。
MTs在CI植入前取出并任其自行排出（59%[n = 46]）或保留至CI植入时（41%[n = 32]）。
记录耳漏、持续性鼓膜（TM）穿孔以及是否需要额外的手术。采用Fisher精确检验进行统计分析。
40只耳朵（51%）需要不止一套MTs。CI植入前取出MTs的10只耳朵（22%）在CI植入后需要单独再次置管，而MTs保留至CI植入时的6只耳朵（19%）在CI植入后需要单独再次置管（P = 0.78）。CI植入时存在的MTs要么在鼓膜成形术时取出（31%[n = 10]），要么在手术后保留（69%[n = 22]）。所有在CI植入前或植入时取出MTs的TM均愈合。有3例持续性TM穿孔需要手术治疗。没有脑膜炎病例，也没有因感染而取出CI的情况。
鼓膜切开置管似乎不会对小儿CI植入受者的最终结局产生不利影响，并且在其他易患中耳炎的儿童中，其处理方式可与MTs类似。对于持续发生复发性急性中耳炎的儿童，MTs可保留；对于不再需要的儿童，MTs可取出。
