Department of Oto-Rhino-Laryngology, Regional Hospital West Jutland, 7500, Holstebro, Denmark.
Department of Oto-Rhino-Laryngology, Regional Hospital West Jutland, 7500, Holstebro, Denmark; Department of Clinical Medicine, Aarhus University, 8200, Aarhus, Denmark.
Int J Pediatr Otorhinolaryngol. 2020 Oct;137:110219. doi: 10.1016/j.ijporl.2020.110219. Epub 2020 Jul 11.
Tympanic membrane perforations might have a negative impact on the patient's quality of life, especially in the pediatric population. Surgery is therefore often required. The most adequate age for surgery remains unclear and is debated in the current literature. The aim of this study was to investigate outcomes of type I tympanoplasty in children and examine the impact of age on surgical outcome.
Retrospective cohort study. All patients under the age of 18 undergoing type I tympanoplasty at Regional Hospital West Jutland, Denmark, from 1/1-2013 to 31/12-2017 had their medical files reviewed. The primary endpoint of interest was tympanic membrane closure rate six months following surgery, i.e. surgical success. Secondary outcomes were air-bone-gap reduction and the correlation between age and surgical success.
A total of 180 patients undergoing 197 procedures met the predefined criteria. Age at the time of surgery ranged between five and 17 years. Mean age at the time of surgery was 10.1 years (95% CI 9.1-11.2). Surgical success was achieved in 91,3% of the cases. No correlation between age and surgical success was found. Mean air-bone gap was reduced from 19.8 dB (95% CI 18.5-21.0) preoperatively, to 6.9 dB (95% CI 6.1-7.7) at follow-up, p < 0.05. Air-bone gaps ≤10 dB at follow-up were achieved in 155 of the cases (78.6%). Postoperative infection seemed to increase the risk of surgical failure, RR 2.80 ((95% CI 1.06-7.38), p = 0.037).
Type 1 tympanoplasty in children is an effective treatment in terms of achieving an intact tympanic membrane and improved hearing. No correlation could be found between age and surgical success. Postoperative infection influences surgical outcome negatively.
鼓膜穿孔可能会对患者的生活质量产生负面影响，尤其是在儿科人群中。因此，通常需要进行手术。最适合手术的年龄仍不清楚，这在当前文献中存在争议。本研究旨在调查儿童 I 型鼓室成形术的结果，并研究年龄对手术结果的影响。
回顾性队列研究。在丹麦西日德兰地区医院，所有年龄在 18 岁以下接受 I 型鼓室成形术的患者，从 2013 年 1 月 1 日至 2017 年 12 月 31 日，其病历均被审查。主要观察终点是术后 6 个月时鼓膜闭合率，即手术成功率。次要结果是气骨导差的减少和年龄与手术成功率之间的相关性。
共有 180 名患者接受了 197 次手术，符合预定标准。手术时的年龄范围为 5 至 17 岁。手术时的平均年龄为 10.1 岁（95%CI 9.1-11.2）。91.3%的病例手术成功。未发现年龄与手术成功率之间存在相关性。平均气骨导差从术前的 19.8dB（95%CI 18.5-21.0）降低到随访时的 6.9dB（95%CI 6.1-7.7），p<0.05。155 例（78.6%）在随访时达到气骨导差≤10dB。术后感染似乎增加了手术失败的风险，RR 2.80（95%CI 1.06-7.38），p=0.037。
儿童 I 型鼓室成形术在实现完整鼓膜和改善听力方面是一种有效的治疗方法。年龄与手术成功率之间没有相关性。术后感染对手术结果有负面影响。
