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2000年至2009年期间,军事医学科学院行鼓膜置管术的分泌性中耳炎患儿的术后早期并发症。

Early postoperative complications in children with secretory otitis media after tympanostomy tube insertion in the Military Medical Academy during 2000-2009.

作者信息

Erdoglija Milan, Sotirović Jelena, Baletić Nenad

机构信息

Clinic for Ear, Nose and Throat, Military Medical Academy, Belgrade, Serbia.

出版信息

Vojnosanit Pregl. 2012 May;69(5):409-13.

Abstract

BACKGROUND/AIM: Secretory otitis media (SOM) is a chronic, nonpurulent inflammation of the middle ear, characterized by a long-term presence of liquids of different density in the middle ear for at least three consecutive months, different degrees of hearing loss and the absence of perforation of the eardrum. The aim of this study was to estimate the early postoperative complications after insertion of tympanostomy tube (TT) in children with secretory otitis media (SOM) in an 18-month period after TT insertion.

METHODS

This retrospective study included children with SOM (n = 478), aged from 2.5 to 16 years, operated from 2000 to 2009. During these ten years 365 children had TT in both ears, 131 children had TT in one ear and 55 children were operated two or more times. Totally 843 ears were operated on. Date were obtained by regular fallow up in Out-patient clinic concerning symptoms reported by children and parents, otomicroscopy findings and hearing measurements (audiometry and tympanometry).

RESULTS

Transient otorrhea was the most common early postoperative complication (16.5%), then obstruction (9.5%), premature extrusion of TT (3.9%), chronic otorrhea (3.1%), granulation tissue (1.1%) and medial displacement (0.5%). According to our experience gold and silicone TT were shown less successful than others. The incidence of premature extrusion of TT was significantly higher with gold TT, comparing to others (6/33, 18%; p < 0.001). We also found significantly more frequent medial displacement with silicone TT than with other ones (2/4, 50%; p < 0.001).

CONCLUSION

There are many early postoperative complications of TT insertion, but they depend on the meticulous surgery techniques, regular postoperative examinations and the type of TT. The type of TT should be determined according to own experience.

摘要

背景/目的:分泌性中耳炎(SOM)是一种中耳的慢性非化脓性炎症,其特征是中耳长期存在不同密度的液体,持续至少三个月,伴有不同程度的听力损失且鼓膜无穿孔。本研究的目的是评估分泌性中耳炎(SOM)患儿在鼓膜置管(TT)插入后18个月内的早期术后并发症。

方法

这项回顾性研究纳入了2000年至2009年期间接受手术的478例年龄在2.5至16岁之间的分泌性中耳炎患儿。在这十年间,365例患儿双耳置入TT,131例患儿单耳置入TT,55例患儿接受了两次或更多次手术。总共843只耳朵接受了手术。通过门诊定期随访获取数据,内容包括患儿和家长报告的症状、耳显微镜检查结果以及听力测量(听力测定和鼓室图)。

结果

短暂性耳漏是最常见的早期术后并发症(16.5%),其次是堵塞(9.5%)、TT过早脱出(3.9%)、慢性耳漏(3.1%)、肉芽组织(1.1%)和向内移位(0.5%)。根据我们的经验,金质和硅酮材质的TT效果不如其他材质。金质TT的TT过早脱出发生率显著高于其他材质(6/33,18%;p<0.001)。我们还发现,硅酮材质TT的向内移位发生率显著高于其他材质(2/4,50%;p<0.001)。

结论

鼓膜置管术后有许多早期并发症,但它们取决于精细的手术技术、定期的术后检查以及TT的类型。应根据自身经验确定TT的类型。

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