Khodaverdi Mojgan, Jørgensen Gita, Lange Theis, Stangerup Sven-Eric, Drozdziewizc Dominika, Tos Mirko, Bonding Per, Caye-Thomasen Per
Department of Oto-Rhino-Laryngology, Copenhagen University Hospital Rigshospitalet/Gentofte, Copenhagen, Denmark.
Int J Pediatr Otorhinolaryngol. 2013 Feb;77(2):241-7. doi: 10.1016/j.ijporl.2012.11.008. Epub 2012 Dec 6.
To determine the long-term hearing following surgical treatment of chronic OME in early childhood (myringotomy or ventilation tube) and to determine the impact of the occurrence and the extension of specific eardrum pathology on the hearing level.
In 1977-1978, 224 consecutive children (91 girls and 133 boys) with chronic bilateral OME were enrolled and treated by adenoidectomy, bilateral myringotomy and insertion of a ventilation tube on the right side only. In 2002, a follow-up examination included otomicroscopy and audiometry. Hearing thresholds were compared to an age- and gender-matched normative data set. For the determination of the impact of specific eardrum pathology on the hearing, multiple linear regression modelling was used in adjustment for age and concomitant eardrum pathologies.
Long-term hearing after chronic OME and associated treatment is not different from age and gender-matched normal hearing. Treatment modality (myringotomy or ventilation tube) has no impact on the long-term hearing level. The regression analyses showed that the presence of myringosclerosis is associated with an overall hearing loss in myringotomised ears (4-5 dB), but not in tubed ears, for which only high frequencies were affected. Conversely, tensa atrophy is associated with an overall hearing loss in tubed ears (3-4 dB), but not in myringotomised ears, for which only high frequencies were affected.
Hearing 25 years after surgical treatment of chronic OME is not different from age and gender matched normal hearing. In addition, treatment modality (myringotomy or ventilation tube) has no impact on the long-term hearing level. However, atrophy is associated with a hearing loss in tubed ears, whereas myringosclerosis is associated with a hearing loss in myringotomised ears. The hearing loss associated with pathology is of limited magnitude (up to about 5 dB PTA). Even though pathology does occur more frequently and more extensively in tubed ears, the effect on the hearing at the group level is too small to have an impact. It is important to note, that this may be due to a type 2-error (number of patients too small to show an effect).
确定幼儿期慢性中耳炎手术治疗（鼓膜切开术或置管术）后的长期听力情况，并确定特定鼓膜病变的发生及范围对听力水平的影响。
1977年至1978年，连续纳入224例双侧慢性中耳炎患儿（91例女孩，133例男孩），均接受腺样体切除术、双侧鼓膜切开术，仅右侧置入通气管。2002年进行随访检查，包括耳显微镜检查和听力测定。将听力阈值与年龄和性别匹配的正常数据集进行比较。为确定特定鼓膜病变对听力的影响，采用多元线性回归模型，对年龄和伴随的鼓膜病变进行校正。
慢性中耳炎及相关治疗后的长期听力与年龄和性别匹配的正常听力无差异。治疗方式（鼓膜切开术或置管术）对长期听力水平无影响。回归分析表明，鼓膜硬化症的存在与鼓膜切开术侧耳的总体听力损失（4 - 5 dB）相关，但在置管侧耳不相关，置管侧耳仅高频听力受影响。相反，鼓膜紧张部萎缩与置管侧耳的总体听力损失（3 - 4 dB）相关，但在鼓膜切开术侧耳不相关，鼓膜切开术侧耳仅高频听力受影响。
慢性中耳炎手术治疗25年后的听力与年龄和性别匹配的正常听力无差异。此外，治疗方式（鼓膜切开术或置管术）对长期听力水平无影响。然而，萎缩与置管侧耳的听力损失相关，而鼓膜硬化症与鼓膜切开术侧耳的听力损失相关。与病变相关的听力损失程度有限（高达约5 dB PTA）。尽管病变在置管侧耳更频繁、更广泛地出现，但在群体水平上对听力的影响太小而无实际影响。需要注意的是，这可能是由于Ⅱ类错误（患者数量太少以至于无法显示出效果）。
