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唐氏综合征与非唐氏综合征慢性中耳炎术前特征的比较。

A comparison of preoperative characteristics of chronic otitis media in Down and non-Down syndrome.

作者信息

Shinnabe Akihiro, Yamamoto Hiroki, Hara Mariko, Hasegawa Masayo, Matsuzawa Shingo, Kanazawa Hiromi, Yoshida Naohiro, Iino Yukiko

机构信息

Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Omiya-ku, Saitama, Japan.

出版信息

Otol Neurotol. 2014 Jul;35(6):972-5. doi: 10.1097/MAO.0000000000000464.

DOI:10.1097/MAO.0000000000000464
PMID:24892364
Abstract

OBJECTIVE

To investigate preoperative clinical findings of chronic otitis media (COM) in patients with Down and without (non-Down) syndrome.

STUDY DESIGN

Retrospective.

SETTING

Referral hospital, otolaryngology department.

PATIENTS

Patients with COM who underwent tympanoplasty were included. There were 10 ears of 8 patients (mean age, 14.9 yr) in the Down group and 44 ears of 41 patients (mean age, 14.7 yr) in the non-Down group.

MAIN OUTCOME MEASURES

Clinical characteristics, including the frequency of preoperative persistent otorrhea, cause of COM, and mastoid pneumatization (maturation), were compared between the 2 groups using clinical records and temporal bone computed tomography (CT).

RESULTS

Preoperative persistent otorrhea was more frequent in the Down group (60%) than in the non-Down group (27.2%; p < 0.05). Perforation due to tympanostomy tube insertion also occurred more frequently in the Down group (100%) than in the non-Down group (53.3%; p < 0.05). Mastoid pneumatization occurred significantly less in the Down group than in the non-Down group (p < 0.01). There was no significant difference in mastoid pneumatization regardless of the presence or absence of a past history of tympanostomy tube insertion in the Down group (p = 0.3, t test) unlike that in the non-Down group (p < 0.05, t test). All ears attained a dry condition with no perforated eardrums.

CONCLUSION

Frequent draining ear and extremely immature mastoid pneumatization, regardless of the presence or absence of a past history of tympanostomy tube insertion, were clinically important characteristics of COM in patients with Down syndrome.

摘要

目的

研究唐氏综合征患者与非唐氏综合征患者慢性中耳炎(COM)的术前临床特征。

研究设计

回顾性研究。

研究地点

转诊医院耳鼻喉科。

患者

纳入接受鼓室成形术的COM患者。唐氏综合征组有8例患者的10只耳(平均年龄14.9岁),非唐氏综合征组有41例患者的44只耳(平均年龄14.7岁)。

主要观察指标

使用临床记录和颞骨计算机断层扫描(CT)比较两组的临床特征,包括术前持续性耳漏的频率、COM的病因以及乳突气化(成熟度)。

结果

唐氏综合征组术前持续性耳漏(60%)比非唐氏综合征组(27.2%)更常见(p<0.05)。唐氏综合征组因鼓膜置管导致的穿孔也比非唐氏综合征组(53.3%)更常见(100%;p<0.05)。唐氏综合征组乳突气化明显少于非唐氏综合征组(p<0.01)。与非唐氏综合征组不同(p<0.05,t检验),唐氏综合征组无论有无鼓膜置管史,乳突气化均无显著差异(p = 0.3,t检验)。所有耳均达到干耳状态,鼓膜无穿孔。

结论

无论有无鼓膜置管史,频繁耳流脓和极度不成熟的乳突气化是唐氏综合征患者COM的重要临床特征。

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