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用温泉水进行咽鼓管吹张:治疗小儿分泌性中耳炎的有效性。

Eustachian tube insufflation with thermal water: Effectiveness in the treatment of pediatric otitis media with effusion.

作者信息

Fermo Salvatore, Frosolini Andrea, Parrino Daniela, Chiappetta Antonio, Marioni Gino, de Filippis Cosimo

机构信息

Department of Neuroscience, Audiology Unit, University of Padova, Treviso, Italy.

Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.

出版信息

Am J Otolaryngol. 2022 Jul-Aug;43(4):103504. doi: 10.1016/j.amjoto.2022.103504. Epub 2022 May 16.

Abstract

PURPOSE

Otitis media with effusion (OME) is the most common ear disease in childhood. The hearing loss associated with OME impacts on children's language development and behavior. Eustachian tube insufflation are among possible treatments for OME, but data regarding their effectiveness are scarce. The aim of this investigation was to analyze the effect of inhalatory thermal therapy and Eustachian tube insufflation in a consecutive cohort of pediatric patients with OME.

MATERIALS AND METHODS

Seventy-four pediatric patients referred for OME to the thermal medical center "La Contea" (Battaglia Terme, Padova, Italy) were considered. Data from tympanometry and pure tone audiometry performed immediately before (T0), at the end of treatment (T1) and at a follow-up control (T2) were analyzed.

RESULTS

Data from 148 ears were available. The pressure values of tympanometry significantly improved from T0 to T1 (p = 0.0001), and further improvement was recorded at T2, when 60.8% of patients had normal tympanograms. A significant gain of the air-conduction threshold in the T0-T2 interval was observed (p = 0.0001). At otoscopy, a significant reduction of tympanic membranes with fluid or air-fluid levels presence (p < 0.00001) and a significant increase of normal tympanic membranes (p = 0.0001) were found.

CONCLUSION

Eustachian tube insufflation represented a well-tolerated and effective treatment in children with OME. Further investigations should deepen these results in randomized, double-blind settings, possibly with long-term follow-up periods. A quality-of-life and cost-effectiveness evaluation of this treatment approach for pediatric OME could be helpful for public health decision-making.

摘要

目的

中耳积液(OME)是儿童期最常见的耳部疾病。与OME相关的听力损失会影响儿童的语言发展和行为。咽鼓管吹张是OME可能的治疗方法之一,但关于其有效性的数据很少。本研究的目的是分析吸入热疗法和咽鼓管吹张对一组连续性儿科OME患者的疗效。

材料与方法

纳入74例因OME转诊至“La Contea”热医学中心(意大利帕多瓦巴塔利亚泰尔梅)的儿科患者。分析了在治疗前(T0)、治疗结束时(T1)和随访对照时(T2)立即进行的鼓室导抗图和纯音听力测试数据。

结果

获得了148只耳朵的数据。鼓室导抗图的压力值从T0到T1有显著改善(p = 0.0001),在T2时进一步改善,此时60.8%的患者鼓室导抗图正常。在T0 - T2间隔内观察到气导阈值有显著提高(p = 0.0001)。耳镜检查发现,有液体或气液平面的鼓膜显著减少(p < 0.00001),正常鼓膜显著增加(p = 0.0001)。

结论

咽鼓管吹张对儿童OME是一种耐受性良好且有效的治疗方法。进一步的研究应在随机、双盲环境中深化这些结果,可能需要长期随访。对这种儿科OME治疗方法进行生活质量和成本效益评估可能有助于公共卫生决策。

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