Department of Otolaryngology, Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
Laryngoscope. 2013 Sep;123(9):2285-90. doi: 10.1002/lary.24021. Epub 2013 Apr 10.
OBJECTIVES/HYPOTHESIS: In children with ventilation tubes (VTs) inserted for chronic otitis media with effusion (COME), the authors sought to determine whether any parameter of Eustachian tube (ET) function measured by the forced response test (FRT) predicts disease recurrence after the VT becomes nonfunctional.
Prospective study of those factors that predict disease recurrence in children with VTs inserted for COME.
Forty-nine subjects (73 ears; 28 male, 34 white, aged 5.3 ± 1.2 years) with COME had VTs inserted and were evaluable for disease status after the VT(s) became nonfunctional. The FRT was done when the VTs were patent, and results for the last test before the VT became nonfunctional were used in the analysis. After each VT became nonfunctional, the children were followed for disease recurrence over a 12-month period. Logistic regression was used to determine whether the ET opening pressure, closing pressure, and/or dilatory efficiency predicted disease recurrence. That model was expanded to include age, sex, race, history of adenoidectomy, previous VTs, and duration of VT patency as potential predictive factors.
Twenty-nine (40%) ears had recurrence of significant disease within 12 months after the VT became nonfunctional. For the complete logistic regression model, male gender (P = .03), nonwhite race (P = .02), shorter period of VT patency (P = .01), and low dilatory efficiency (P = .01) were significant predictors of disease recurrence.
A measure of active ET function, dilatory efficiency, but not measures of passive function predicted disease recurrence within the 12 months after the VT became nonfunctional in children with COME.
目的/假设：本研究旨在探讨对于因慢性分泌性中耳炎（OME）而置入通气管（VT）的儿童，咽鼓管（ET）功能的任何参数能否预测 VT 失效后疾病的复发。
对因OME 而置入 VT 的儿童进行前瞻性研究，以预测 VT 失效后疾病复发的相关因素。
49 名受试者（73 耳；28 名男性，34 名白人，年龄 5.3±1.2 岁）因OME 而置入 VT，并在 VT 失效后对疾病状态进行评估。当 VT 通畅时进行强制反应测试（FRT），并使用 VT 失效前的最后一次测试结果进行分析。每根 VT 失效后，通过 12 个月的随访来观察疾病的复发情况。采用逻辑回归分析来判断 ET 开放压、关闭压和/或扩张效率是否能预测疾病的复发。该模型扩展到包括年龄、性别、种族、腺样体切除术史、先前的 VT 以及 VT 通畅时间等潜在预测因素。
29 只（40%）耳在 VT 失效后 12 个月内出现了明显的疾病复发。对于完整的逻辑回归模型，男性（P=0.03）、非白种人（P=0.02）、VT 通畅时间较短（P=0.01）和扩张效率低（P=0.01）是疾病复发的显著预测因素。
在因OME 而置入 VT 的儿童中，ET 主动功能的一个测量指标，即扩张效率，而不是被动功能的测量指标，可以预测 VT 失效后 12 个月内的疾病复发。
