Department of Otorhinolaryngology, Head and Neck Surgery, University of Munich, Munich, Germany.
Otol Neurotol. 2012 Aug;33(6):983-7. doi: 10.1097/MAO.0b013e318259b70b.
Most clinical studies on adverse effects and extrusion rates of tympanostomy tubes have been conducted with children undergoing treatment because of recurrent acute otitis media or chronic otitis media with effusion. Little is known, however, about post tympanostomy complications and extrusion rates in healthy middle ears. In this study, we analyzed extrusion rates and adverse effects of fluoroplastic, titanium, and gold ventilation tubes of different sizes in adult patients with Ménière's disease.
Clinical record study including 108 patients.
Otorrhea occurred in 18% of fluoroplastic tubes but only 4% of titanium tubes. Permanent occlusion was observed in 22% of fluorplastic but only 4% of titanium tubes. No statistical difference was seen for transient dysfunction and tube extrusion rates. Granulations and chronic perforations were not observed.
The low rate of infections and permanent occlusions for titanium tubes as well as the lack of granulations and chronic perforations for all tubes might be due to the fact that our patients were adults with healthy middle ears. Furthermore, a better biocompatibility of titanium in the middle ear compared with gold or synthetic materials has been observed for protheses used to rebuild the sound conductive apparatus of the middle ear.
Titanium tubes might be the better choice for adult patients lacking Eustachian tube dysfunction and otitis media with effusion. Ventilation tubes in adults with healthy middle ears seem to be less associated with adverse effects compared with ventilation tubes in children with otitis media with effusion or recurrent otitis media.
大多数关于鼓室造口管不良影响和脱出率的临床研究都是针对因复发性急性中耳炎或慢性分泌性中耳炎而接受治疗的儿童进行的。然而，对于健康中耳鼓室造口后的并发症和脱出率知之甚少。在这项研究中，我们分析了不同大小的氟塑料、钛和金通风管在梅尼埃病成年患者中的脱出率和不良影响。
包括 108 例患者的临床记录研究。
氟塑料管出现耳漏的比例为 18%，而钛管仅为 4%。氟塑料管出现永久性阻塞的比例为 22%，而钛管仅为 4%。瞬态功能障碍和管脱出率无统计学差异。未观察到肉芽组织和慢性穿孔。
钛管感染和永久性阻塞的发生率较低，所有管均无肉芽组织和慢性穿孔，这可能是由于我们的患者为健康中耳的成年患者。此外，与金或合成材料相比，钛在中耳中的生物相容性更好，已用于重建中耳传音装置的假体中。
对于缺乏咽鼓管功能障碍和分泌性中耳炎的成年患者，钛管可能是更好的选择。与分泌性中耳炎或复发性中耳炎的儿童相比，健康中耳的成年人使用通气管的不良影响似乎较少。
