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一种使用改良型静脉留置针治疗耳气压伤的新方法。

A novel technique of otic barotrauma management using modified intravenous cannulae.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Prince of Wales Hospital, Sydney, NSW 2031, Australia.

出版信息

Eur Arch Otorhinolaryngol. 2013 Sep;270(10):2627-30. doi: 10.1007/s00405-012-2301-3. Epub 2012 Dec 4.

Abstract

This article provides the first detailed description and systematic evaluation of the management of otic barotrauma using modified intravenous cannulae. A 24-gauge IC cannula was modified as a tool for tympanostomy tube placement and middle ear ventilation. The medical records of 271 ears of 156 adult patients (median age 49 years) who underwent this procedure were reviewed retrospectively. Hundred and ninty-one tubes were placed for otalgia because of hyperbaric oxygen therapy, 58 tubes were inserted for air travel prophylaxis and 22 tubes were placed for management of otic barotrauma post-flight. All the patients who had this procedure for prophylaxis experienced regular otic barotrauma symptoms during air travel prior to tube placement. All patients were reviewed 6 weeks (range 2-9 weeks) post-procedure. This technique of otic barotrauma management worked effectively in 99 % of treated patients. On follow-up, 88 % of tubes were found to be extruded and non-extruded tubes were removed in clinic without any anaesthesia. 99.6 % of tympanic membrane had healed completely and spontaneously without sequelae. Given the safety, effectiveness, low risk of complications associated with this novel tympanostomy technique, it provided a simple yet effective therapeutic option for the management of otic barotrauma. Finally, this technique can be easily applied in all health settings as it only requires medical supplies readily available in hospitals, therefore there is no additional cost.

摘要

这篇文章首次详细描述并系统评估了使用改良静脉插管治疗耳气压伤的方法。我们将 24 号静脉留置针改装为鼓膜切开管置管和中耳通气的工具。回顾性分析了 156 例成年患者(中位年龄 49 岁)271 耳接受该操作的病历。91 例因高压氧治疗耳痛而置管,58 例为航空旅行预防而置管,22 例为飞行后耳气压伤管理而置管。所有接受该预防措施的患者在置管前的航空旅行中均经历过常规耳气压伤症状。所有患者均在术后 6 周(2-9 周)进行了随访。这种耳气压伤管理技术在 99%的治疗患者中有效。随访时,88%的管子被挤出,未挤出的管子在没有任何麻醉的情况下在诊所取出。99.6%的鼓膜完全自发愈合,无后遗症。鉴于这种新型鼓膜切开技术的安全性、有效性和低并发症风险,它为耳气压伤的管理提供了一种简单而有效的治疗选择。最后,由于该技术仅需要医院内随时可用的医疗用品,因此可以在所有医疗环境中轻松应用,因此没有额外的成本。

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