Division of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Laryngoscope. 2013 Feb;123(2):376-80. doi: 10.1002/lary.23684. Epub 2012 Sep 5.
OBJECTIVES/HYPOTHESIS: The use of myringotomy with ventilation tube insertion after maxillary swing nasopharyngectomy was originally described to prevent the occurrence of otitis media with effusion. The outcome of this otologic procedure has never been reviewed and discussed. The purpose of this study is to examine the role of myringotomy with ventilation tube insertion in this group of patients.
Retrospective review.
One hundred forty-two patients with maxillary swing nasopharyngectomy were recruited from 1999 to 2008. The otologic status was evaluated using otoscopy, pure tone audiogram, and tympanogram at 3 months, 6 months, and then yearly after the operation. The results were reviewed periodically during that 10-year period. During this period, there were three groups; the first group had myringotomy with ventilation tube inserted, the second group had myringotomy alone, and the third group had no myringotomy performed.
There were significantly (P < .0001) more patients in the myringotomy with ventilation tube insertion group who suffered from adverse otologic complications such as discharging grommet, discharging chronic suppurative otitis media, and perforated eardrum when compared with patients with myringotomy alone and patients without myringotomy at 3 months, 6 months, and 12 months. There were no differences in the incidence of acute otitis media among all three groups of patients.
Patients who underwent maxillary swing nasopharyngectomy and myringotomy with ventilation tube insertions suffered from more otologic complications. The routine use of myringotomy with or without ventilation tube insertion for this group of patients is not recommended.
目的/假设:上颌摆动经鼻咽切除术(maxillary swing nasopharyngectomy)后行鼓膜切开并置管术最初被描述为预防分泌性中耳炎的发生。但这种耳科手术的结果从未被回顾和讨论过。本研究的目的是检查此类患者行鼓膜切开并置管术的作用。
回顾性研究。
从 1999 年至 2008 年,共招募了 142 例接受上颌摆动经鼻咽切除术的患者。在术后 3 个月、6 个月和之后每年,使用耳镜、纯音听力图和鼓室图评估耳科状况。在这 10 年期间定期进行复查。在此期间,有三组患者:第一组进行鼓膜切开并置管,第二组仅进行鼓膜切开,第三组则未进行鼓膜切开。
与单独行鼓膜切开术组和未行鼓膜切开术组相比,行鼓膜切开并置管术组患者在术后 3 个月、6 个月和 12 个月时出现耳科并发症(如置管排出、慢性化脓性中耳炎和鼓膜穿孔)的患者明显更多(P<0.0001)。三组患者的急性中耳炎发生率无差异。
接受上颌摆动经鼻咽切除术和鼓膜切开并置管术的患者出现更多的耳科并发症。不推荐常规对这组患者行鼓膜切开并置管术或单独行鼓膜切开术。