Branco Carla, Paço João
ENT Department, Hospital de Vila Franca de Xira, Lisboa, Portugal.
ENT Department, Hospital CUF Infante Santo, Lisboa, Portugal.
Acta Otorrinolaringol Esp (Engl Ed). 2017 Nov-Dec;68(6):323-327. doi: 10.1016/j.otorri.2017.02.003. Epub 2017 May 15.
Myringosclerosis is one of the most frequent late complications of the insertion of ventilation tubes, and its aetiopathogenesis remains unknown. The calcification that occurs in the formation of myringosclerosis plaque raises the hypothesis of the presence of a calcium metabolism disorder. The objective is to determine whether calcemia contributes to the development of myringoscelerosis after insertion of ventilation tubes.
A longitudinal, prospective, analytical cohort study was conducted in patients undergoing myringotomy with the insertion of ventilation tubes due to otitis media with effusion. Calcemia was evaluated pre-operatively and in the follow-up the appearance of myringosclerosis and the percentage of the tympanum involved were evaluated.
The study included 156 patients (297 ears), with calcemia values ranging from 7.6 to 10.2mg/dl. Myringosclerosis was identified in 35.4% of the operated ears. No relationship was found between the appearance of myringosclerosis and calcemia (p=.596). It was found, however, that the greater the percentage of the tympanum affected by myringosclerosis, the lower the calcemia values (p=.014).
The population studied had calcemia values within the normal range, which allows us to infer that no changes in calcium metabolism are required for the development of myringosclerosis. Moreover, unlike in previous studies, higher calcium levels are not associated with more myringosclerosis. Calcemia did not influence the appearance of myringosclerosis after myringotomy with the insertion of ventilation tubes.
鼓膜硬化是鼓膜置管最常见的晚期并发症之一,其发病机制尚不清楚。鼓膜硬化斑形成过程中出现的钙化引发了钙代谢紊乱存在的假说。目的是确定血钙水平是否有助于鼓膜置管后置鼓膜硬化的发展。
对因分泌性中耳炎接受鼓膜切开置管术的患者进行了一项纵向、前瞻性分析队列研究。术前评估血钙水平,随访时评估鼓膜硬化的出现情况及鼓膜受累百分比。
该研究纳入了156例患者(297耳),血钙值范围为7.6至10.2mg/dl。在35.4%的手术耳中发现了鼓膜硬化。未发现鼓膜硬化的出现与血钙水平之间存在关联(p = 0.596)。然而,发现鼓膜硬化累及鼓膜的百分比越高,血钙值越低(p = 0.014)。
所研究的人群血钙值在正常范围内,这使我们能够推断鼓膜硬化的发展不需要钙代谢发生变化。此外,与以往研究不同,较高的钙水平与更多的鼓膜硬化无关。血钙水平并未影响鼓膜切开置管术后鼓膜硬化的出现。