142902Pittsburgh Ear Associates, Allegheny General Hospital, Pittsburgh, PA, USA.
Ear Nose Throat J. 2020 Nov;99(1_suppl):35S-38S. doi: 10.1177/0145561320913350. Epub 2020 Mar 19.
To discuss the indication for performing a mastoidectomy with catheter placement in patients with chronic tympanostomy tube otorrhea.
The Medical Literature Analysis and Retrieval System Online was searched via PubMed for relevant articles using serous mastoiditis, mastoidectomy, chronic otorrhea, tube otorrhea, tympanostomy tubes, and biofilm as keywords.
Further understanding of the pathophysiology of otorrhea and the development of ototopical fluoroquinolones have made a draining tympanostomy tube more manageable. Nevertheless, chronic otorrhea refractory to an otolaryngologist's traditional treatment algorithm still occurs and may benefit from a mastoidectomy with antibiotic irrigation using a catheter in certain cases. We theorize that resolution of otorrhea results from this technique by decreasing the burden of diseased mucosa and providing a larger concentration or dose of antibiotic to the middle ear cleft through the antrum. High-resolution images of the technique and catheter placement are included in this review.
Despite being an uncommon management strategy, the literature suggests an indication for performing a mastoidectomy in a small percentage of patients with a chronically draining tympanostomy tube.
探讨在慢性鼓膜置管耳漏患者中行乳突切除术并置管引流的适应证。
通过 PubMed 检索 Medical Literature Analysis and Retrieval System Online 数据库，使用浆液性乳突炎、乳突切除术、慢性耳漏、置管耳漏、鼓膜置管和生物膜作为关键词检索相关文章。
对耳漏病理生理学的进一步了解和局部用氟喹诺酮类药物的发展，使引流鼓膜置管管变得更易于管理。然而，仍有一些慢性耳漏对耳鼻喉科医生的传统治疗方案无反应，在某些情况下，通过乳突切除术并用导管进行抗生素冲洗可能会从中获益。我们推测，该技术通过减少患病黏膜的负担，并通过鼓窦向中耳腔提供更高浓度或更大剂量的抗生素，从而使耳漏得到缓解。本综述中包含了该技术和导管放置的高分辨率图像。
尽管这是一种不太常见的治疗策略，但文献表明，对于一小部分慢性鼓膜置管引流的患者，行乳突切除术是有适应证的。
