不进行乳突切除术的鼓室成形术治疗耐甲氧西林金黄色葡萄球菌感染的慢性中耳炎的疗效

Efficacy of tympanoplasty without mastoidectomy on MRSA-infected chronic otitis media.

作者信息

Yang Hyung Chae, Cho Yong Beom, Jang Chul Ho

机构信息

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea.

出版信息

Otol Neurotol. 2014 Jul;35(6):976-80. doi: 10.1097/MAO.0000000000000296.

DOI:10.1097/MAO.0000000000000296

PMID:24751745

Abstract

OBJECTIVES/HYPOTHESIS: The prevalence of methicillin-resistant Staphylococcus aureus (MRSA)-infected chronic otitis media (COM) has been increasing, but to date, there has been no consensus on surgical treatment. Although there is a report that mastoidectomy is essential in treating MRSA-infected COM, in our experience, we found that tympanoplasty without mastoidectomy was sufficient. In this study, we evaluated the efficacy of tympanoplasty without mastoidectomy on MRSA-infected COM.

STUDY DESIGN

Retrospective case-control study.

METHODS

Forty ears with MRSA-infected COM that underwent tympanoplasty without mastoidectomy were identified at a tertiary referral center from February 2006 to September 2011. Each case had two controls matched. Hearing results and postoperative complication were examined to evaluate the efficacy of tympanoplasty. The preoperative and postoperative pure tone audiometry was checked.

RESULTS

In the MRSA group and control group, 5 out of 40 ears (12.5%) and 8 out of 80 ears (10%) showed postoperative complications, respectively. The hearing success rate was 95.8% (23/24) in the MRSA group and 91.7% (44/48) in the control group. In the MRSA group, the average air-bone gap was 20 dB preoperatively, and it improved to 14 dB postoperatively. In the control group, the average air-bone gap was 19 dB preoperatively, and it improved to 13 dB postoperatively. There was no statistically significant difference between the MRSA and control groups.

CONCLUSIONS

Tympanoplasty without mastoidectomy showed efficacy in MRSA-infected COM.

摘要

目的/假设：耐甲氧西林金黄色葡萄球菌（MRSA）感染的慢性中耳炎（COM）的患病率一直在上升，但迄今为止，手术治疗尚无共识。虽然有报告称乳突切除术对治疗MRSA感染的COM至关重要，但根据我们的经验，我们发现不进行乳突切除术的鼓室成形术就足够了。在本研究中，我们评估了不进行乳突切除术的鼓室成形术对MRSA感染的COM的疗效。

研究设计

回顾性病例对照研究。

方法

2006年2月至2011年9月在一家三级转诊中心确定了40例接受了不进行乳突切除术的鼓室成形术的MRSA感染的COM患者。每个病例匹配两个对照。检查听力结果和术后并发症以评估鼓室成形术的疗效。检查术前和术后纯音听力测定。

结果

MRSA组和对照组中，40耳中有5耳（12.5%）和80耳中有8耳（10%）分别出现术后并发症。MRSA组的听力成功率为95.8%（23/24），对照组为91.7%（44/48）。在MRSA组中，术前平均气骨导间距为20 dB，术后改善至14 dB。在对照组中，术前平均气骨导间距为19 dB，术后改善至13 dB。MRSA组和对照组之间无统计学显著差异。