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使用自动充气装置并不会导致分泌性中耳炎儿童的听力阈值发生有临床意义的变化。

Use of an autoinflation device does not lead to a clinically meaningful change in hearing thresholds in children with otitis media with effusion.

机构信息

Audiology Department, Royal Berkshire NHS Foundation Trust, Reading, UK.

The UCL Ear Institute, London, UK.

出版信息

Clin Otolaryngol. 2022 Jan;47(1):160-166. doi: 10.1111/coa.13879. Epub 2021 Nov 10.

DOI:10.1111/coa.13879
PMID:34676985
Abstract

DESIGN

The objective of this study was to establish whether autoinflation was an effective intervention in a paediatric audiology service. This was a pragmatic retrospective study with historical controls using a paired availability design.

SETTING

The study took place at a single paediatric audiology service in England.

PARTICIPANTS

All children seen in the clinic over a two-year period who were aged between 3 and 11 years and who had a type B tympanogram in at least one ear were included. The Otovent autoinflation device was available as a treatment option over the second year (Cohort B) but not the first (Cohort A). There were 976 children included in the study: Cohort A comprised 513 children, Cohort B comprised 463 children.

MAIN OUTCOME MEASURES

The aims were to evaluate whether there was improvement in hearing thresholds following introduction of an autoinflation device, and whether there was a reduction in further audiology follow-ups, and in referrals to an ear, nose and throat specialist for consideration of ventilation tube insertion.

RESULTS AND CONCLUSIONS

There was a statistically significant improvement in hearing thresholds in Cohort B compared to Cohort A, however the improvements were clinically minimal with small effect sizes. There was no significant difference in improvement of tympanometry results between the two cohorts. Significantly more children in Cohort B (autoinflation group) were referred to an ear, nose and throat specialist after their second appointment compared to Cohort A. It was feasible to introduce autoinflation into the care pathway, however there was no evidence of clinically meaningful improved outcomes for patients.

摘要

设计

本研究旨在确定自动充气是否是儿科听力学服务中的有效干预措施。这是一项具有历史对照的实用性回顾性研究,采用配对可用性设计。

地点

研究在英国的一个儿科听力学服务机构进行。

参与者

所有在诊所就诊的年龄在 3 至 11 岁之间且至少一只耳朵的鼓室图为 B 型的儿童均被纳入研究。在第二年(B 队列)提供 Otovent 自动充气设备作为治疗选择,但在第一年(A 队列)不提供。共有 976 名儿童被纳入研究:A 队列包括 513 名儿童,B 队列包括 463 名儿童。

主要观察指标

目的是评估引入自动充气设备后听力阈值是否有所改善,以及是否减少了进一步的听力学随访次数,以及减少了因考虑通气管插入而向耳鼻喉科专家转诊的次数。

结果和结论

与 A 队列相比,B 队列的听力阈值有统计学显著改善,但改善程度很小,效果较小。两组之间的鼓室图结果改善无显著差异。与 A 队列相比,B 队列(自动充气组)中更多的儿童在第二次就诊后被转诊至耳鼻喉科专家。将自动充气纳入护理路径是可行的,但没有证据表明患者的临床结局有明显改善。

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