Kim Dongwon, Choi Sung-Won, Lee Hyun-Min, Kong Soo-Keun, Lee Il-Woo, Oh Se-Joon
Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea.
Auris Nasus Larynx. 2019 Jun;46(3):311-318. doi: 10.1016/j.anl.2018.09.002. Epub 2018 Sep 15.
This study aimed to assess the differences in the extrusion rate, patency and incidence of otorrhea according to the material properties of tubes in tympanostomy tube (TT) procedures.
A total of 75 children with bilateral chronic otitis media with effusion were randomized in this prospective trial to receive 1.02-mm-sized TTs (thermoplastic elastomer) in one ear and 1.14-mm-sized TTs (silicone) in the other ear. Data were obtained on ventilation tube type, time to extrusion, comorbidities, tube plugging, incidence of TT otorrhea during following up, and age of the patient. Postoperatively, follow-up by an otologist continued every two months to assess the incidence of otorrhea, plugging, and TT extrusion until all tubes were extruded.
Out of the 75 children, 7 patients were excluded during surgery and 4 were lost during follow-up. The mean extrusion time of 1.02-mm-sized TTs (thermoplastic elastomer) was 10.28 months, whereas that of 1.14-mm-sized TTs (silicone) was 7.36 months, which showed a significant difference. However, thermoplastic elastomer TTs had more plugging events than silicone TTs.
There was a significant increase in the time to extrusion in ears with the 1.02-mm-sized thermoplastic elastomer TT, although, generally, the larger inner diameter of the tube last longer in the eardrum. This contrasting result is thought to be due to the different material properties of both TTs. This information may be helpful for TT selection in clinical practice depending on the patient's condition.
本研究旨在评估在鼓膜置管术（TT）中，根据置管材料特性，评估置管的排出率、通畅率和耳漏发生率的差异。
在这项前瞻性试验中，共有75例双侧慢性分泌性中耳炎患儿被随机分配，一只耳朵植入1.02毫米大小的TT（热塑性弹性体），另一只耳朵植入1.14毫米大小的TT（硅胶）。收集了关于通气管类型、排出时间、合并症、通气管堵塞情况、随访期间TT耳漏发生率以及患者年龄的数据。术后，耳鼻喉科医生每两个月进行一次随访，以评估耳漏、堵塞和TT排出的发生率，直至所有置管排出。
75例患儿中，7例在手术期间被排除，4例在随访期间失访。1.02毫米大小的TT（热塑性弹性体）的平均排出时间为10.28个月，而1.14毫米大小的TT（硅胶）的平均排出时间为7.36个月，两者存在显著差异。然而，热塑性弹性体TT的堵塞事件比硅胶TT更多。
尽管一般来说，内径较大的置管在鼓膜内留存时间更长，但植入1.02毫米大小热塑性弹性体TT的耳朵，其置管排出时间显著延长。这种相反的结果被认为是由于两种TT的材料特性不同。这些信息可能有助于根据患者情况在临床实践中选择TT。
