Erdurak Selcuk Cem, Coskun Berna Uslu, Sakalli Erdal, Tansuker Hasan Deniz, Turan Fatih, Kaya Deniz
Department of Otorhinolaryngology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2014 Mar;271(3):459-62. doi: 10.1007/s00405-013-2433-0. Epub 2013 Mar 15.
The aim of the present study was to determine the rate of myringosclerosis after radiofrequency (RF) myringotomy and ventilation tube (VT) insertion and compare it with that after the incisional myringotomy and VT insertion. Thirty children (60 ears), 2-16 years old (mean age 7.06 ± 2.77 years) who were planned to undergo surgical intervention for bilateral otitis media with effusion (OME), were included in this study. The children were treated by RF myringotomy of the right ear, incisional myringotomy of the left ear, and insertion of VTs into both ears. Both ears were examined intraoperatively for bleeding, and patients were evaluated for myringosclerosis formation with otomicroscopy at the end of the ninth month. Myringosclerosis was observed in 22 of the 60 ears. The overall incidence was 36.6 %. Fifteen (50 %) left ears showed myringosclerosis by otomicroscopy, and seven (23.3 %) right ears showed myringosclerosis. The rate of myringosclerosis of the right ear was significantly lower than that of the left ear (p < 0.05). In addition, intraoperative tympanic membrane bleeding was observed in 24 (40 %) of the 60 ears: 21 (70 %) left ears and three (10 %) right ears were perforated by RF. The tympanic membrane bleeding rate of the right ear was significantly lower than that of the left ear (p < 0.01). The present study is the first to determine the myringosclerosis rate after RF myringotomy and VT insertion. Our results indicate that VT insertion with RF myringotomy decreased the incidence of myringosclerosis.
本研究的目的是确定射频(RF)鼓膜切开术和置管(VT)插入术后鼓膜硬化的发生率,并将其与切开鼓膜切开术和VT插入术后的发生率进行比较。本研究纳入了30名2至16岁(平均年龄7.06±2.77岁)计划接受双侧分泌性中耳炎(OME)手术干预的儿童(60只耳)。这些儿童接受了右耳的RF鼓膜切开术、左耳的切开鼓膜切开术以及双耳的VT插入术。术中检查双耳有无出血,并在第九个月末用耳显微镜评估患者鼓膜硬化的形成情况。60只耳中有22只观察到鼓膜硬化。总发生率为36.6%。耳显微镜检查显示15只(50%)左耳出现鼓膜硬化,7只(23.3%)右耳出现鼓膜硬化。右耳鼓膜硬化率显著低于左耳(p<0.05)。此外,60只耳中有24只(40%)术中观察到鼓膜出血:21只(70%)左耳和3只(10%)右耳因RF穿孔。右耳鼓膜出血率显著低于左耳(p<0.01)。本研究首次确定了RF鼓膜切开术和VT插入术后的鼓膜硬化率。我们的结果表明,RF鼓膜切开术联合VT插入术可降低鼓膜硬化的发生率。