1 Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA.
2 Intermountain Healthcare, Surgical Services Clinical Program, Murray, Utah, USA.
Otolaryngol Head Neck Surg. 2018 May;158(5):930-933. doi: 10.1177/0194599817752633. Epub 2018 Jan 16.
Objectives Review the incidence of long-term sequelae after placement of tympanostomy tubes. Study Design Case series with chart review. Setting Multihospital network. Subjects Patients 0 to 3 years old undergoing tympanostomy tube (TT) placement. Methods A case series of 14,058 children between 2004 and 2010 was reviewed. The patients were followed for 5 years to determine number of repeated tube placements, need for surgical removal of tubes, and presence of perforation requiring repair. Results The study cohort included 14,058 children who underwent TT placement. The mean age at time of procedure was 1.4 years. A total of 14.4% of patients required a second set of tubes within the 5 years of follow-up studied, and 4.6% required 3 or more sets. Three percent required removal of a tube, and this occurred at an average time of 34.2 ± 17.6 months postplacement. In total, 5.1% had a resulting perforation after either tube extrusion or tube removal requiring myringoplasty. Conclusions The rate of multiple tube placements and myringoplasty and tympanoplasty to correct resulting perforations has yet to be studied in a single large population. This information allows for more detailed preoperative counseling to patients and families. Better characterization of these populations with accurate rates of sequelae can help to tailor treatment and preoperative counseling in the future.
回顾鼓膜置管后长期后遗症的发生情况。
病例系列,伴有图表回顾。
多医院网络。
2004 年至 2010 年间接受鼓膜置管术(TT)的 0 至 3 岁患者。
对 14058 例儿童进行了病例系列回顾。这些患者随访 5 年,以确定重复置管次数、是否需要手术取出管、以及是否存在需要修复的穿孔。
研究队列包括 14058 名接受 TT 置管的儿童。手术时的平均年龄为 1.4 岁。在 5 年的随访中,共有 14.4%的患者需要在第二次置管,4.6%的患者需要 3 次或更多次置管。3%的患者需要取出管,平均时间为置管后 34.2±17.6 个月。总共有 5.1%的患者在管脱出或管取出后出现穿孔,需要进行鼓膜成形术。
在单一大型人群中,尚未研究多次置管和鼓膜成形术及鼓室成形术以纠正由此产生的穿孔的发生率。这些信息可以为患者和家属提供更详细的术前咨询。更好地描述这些具有准确后遗症发生率的人群,有助于未来调整治疗和术前咨询。