Weigel M T, Parker M Y, Goldsmith M M, Postma D S, Pillsbury H C
Division of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7070.
Laryngoscope. 1989 Mar;99(3):252-6. doi: 10.1288/00005537-198903000-00003.
Tympanostomy tube placement has clearly been shown to be an efficacious treatment for recurrent bouts of acute otitis media or chronic otitis media with effusion. However, there are few objective, prospective, randomized studies present in the literature to aid the clinical otolaryngologist with the proper tube choice for middle ear aeration. A prospective, randomized study was undertaken of four commonly used tympanostomy tubes. Shepard Teflon grommet, Armstrong beveled tube, Reuter-Bobbin tube, and Goode T-tube. This study was undertaken to determine which of these tubes had the fewest number of postplacement complications, including otorrhea, plugging, residual perforation, or chronic persistence in the tympanic membrane. Average follow-up was 17 months. The Shepard and Armstrong tubes showed a comparatively low rate of plugging and otorrhea. Both tubes had extrusion times that averaged less than 1 year. The Reuter-Bobbin tube had a much greater rate of plugging, compared to the other tubes. The T-tube had an increased incidence of otorrhea and persistence in the tympanic membrane well beyond 1 year. The T-tube was also the only tube in this study associated with residual perforations.
鼓膜置管已被明确证明是治疗复发性急性中耳炎或伴有积液的慢性中耳炎的有效方法。然而，文献中几乎没有客观、前瞻性、随机研究来帮助临床耳鼻喉科医生选择合适的中耳通气置管。对四种常用的鼓膜置管进行了一项前瞻性、随机研究。分别是谢泼德聚四氟乙烯索环、阿姆斯特朗斜口管、罗伊特-线轴管和古德T型管。本研究旨在确定这些置管中哪种置管后并发症最少，包括耳漏、堵塞、残余穿孔或鼓膜慢性存留。平均随访时间为17个月。谢泼德管和阿姆斯特朗管的堵塞和耳漏发生率相对较低。两种置管的脱出时间平均不到1年。与其他置管相比，罗伊特-线轴管的堵塞发生率要高得多。T型管的耳漏发生率增加，且鼓膜存留时间远超过1年。T型管也是本研究中唯一与残余穿孔相关的置管。
