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鼓膜外伤性穿孔:80例病例回顾

Traumatic Perforation of the Tympanic Membrane: A Review of 80 Cases.

作者信息

Sagiv Doron, Migirov Lela, Glikson Eran, Mansour Jobran, Yousovich Ruth, Wolf Michael, Shapira Yisgav

机构信息

Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

J Emerg Med. 2018 Feb;54(2):186-190. doi: 10.1016/j.jemermed.2017.09.018. Epub 2017 Oct 28.

Abstract

BACKGROUND

Traumatic perforation of the tympanic membrane (TPTM) is often encountered in primary care or in the emergency department (ED). Several therapeutic interventions have been described, but conservative follow-up until spontaneous complete recovery is the most common choice.

OBJECTIVE

Our goal was to analyze the trauma mechanism, perforation characteristics, and outcome of patients with TPTM.

METHODS

The study included patients examined in the ED of a tertiary, university-affiliated medical center because of TPTM between 2012 and 2016. Their medical records were retrospectively reviewed for demographics, trauma mechanism, clinical characteristics, and outcome. A phone survey was performed to obtain the missing information of all the patients who did not continue their follow-up in our outpatient clinic.

RESULTS

We reviewed the histories of 80 patients with a mean age of 26.7 ± 14.6 years (20 children; 25%). TPTM was caused by blunt trauma in 45 patients (56%) and penetrating trauma in 35 patients (44%). Thirty-five patients (44%) completed their follow-up in the hospital outpatient clinic, with a mean duration of 6.2 weeks. Twenty-five patients (38%) completed their follow-up in a community-based otolaryngology clinic, 6 patients (9%) chose not to complete their follow-up, and 14 patients were lost to follow-up. Of the 60 patients who completed follow-up, 56 patients recovered spontaneously, 3 patients underwent successful tympanoplasty, and 1 patient was referred to surgery but was lost to follow-up. All children healed spontaneously.

CONCLUSION

TPTM was more common in young males with main mechanisms of blunt trauma (an assault) or cleaning the ear canal. All children demonstrated complete spontaneous recovery.

摘要

背景

鼓膜外伤性穿孔(TPTM)在初级保健或急诊科(ED)中经常遇到。已经描述了几种治疗干预措施,但保守随访直至自发完全恢复是最常见的选择。

目的

我们的目标是分析TPTM患者的创伤机制、穿孔特征和结局。

方法

该研究纳入了2012年至2016年间因TPTM在一所大学附属三级医疗中心急诊科接受检查的患者。对他们的病历进行回顾性审查,以了解人口统计学、创伤机制、临床特征和结局。进行电话调查以获取所有未在我们门诊继续随访的患者的缺失信息。

结果

我们回顾了80例患者的病史,平均年龄为26.7±14.6岁(20名儿童;25%)。45例患者(56%)的TPTM由钝性创伤引起,35例患者(44%)由穿透性创伤引起。35例患者(44%)在医院门诊完成了随访,平均持续时间为6.2周。25例患者(38%)在社区耳鼻喉科诊所完成随访,6例患者(9%)选择不完成随访,14例患者失访。在完成随访的60例患者中,56例自发恢复,3例成功接受了鼓膜成形术,1例被转诊手术但失访。所有儿童均自发愈合

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