自动充气与通气管治疗分泌性中耳炎的比较。
Autoinflation compared to ventilation tubes for treating chronic otitis media with effusion.
机构信息
Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Regenerative Medicine Program, Department of Biomedical Sciences and Medicine, University of Algarve, Campus da Penha, Faro, Portugal.
出版信息
Acta Otolaryngol. 2022 Jun;142(6):476-483. doi: 10.1080/00016489.2022.2088855. Epub 2022 Jul 5.
BACKGROUND
Otitis media with effusion (OME) is the most common cause of acquired hearing loss and surgery in children. Autoinflation has been suggested as an alternative treatment for OME.
OBJECTIVES
The aim of the study was to compare treatment outcome with a new autoinflation device versus ventilation tube (VT) surgery or watchful waiting in children with chronic bilateral OME from the waiting list for surgery.
METHODS
Forty-five children performed autoinflation during four weeks, forty-five were submitted to VT surgery, and twenty-three were enrolled as control group. Tympanometry was performed in the autoinflation and the control groups and audiometry in all groups.
RESULTS
An equivalent hearing improvement was achieved in the autoinflation and the VT group at one (=.19), six (=.23) and twelve (=.31) months with no significant alteration in the control group. In the autoinflation group 80% of the children avoided surgery and no complications were reported compared to 34% complication rate in the VT group.
CONCLUSION
Autoinflation achieved an equivalent improvement in hearing thresholds compared to VT surgery for treating OME.
SIGNIFICANCE
Autoinflation may be a reasonable first-line treatment for children with OME to potentially avoid surgery. The Moniri autoinflation device is well tolerated and an effective alternative to ventilation tubes for treatment of chronic otitis media with effusion in young children. Previous studies have shown that autoinflation may reduce effusion in children with otitis media with effusion; however limited compliance to treatment, lack of adequate hearing evaluation, short follow-up time and also lack of comparative data to ventilation tube surgery have been reported. A new device was developed to allow for the performance of autoinflation in young children. The effect is compared to ventilation tube surgery and equivalent improvement in hearing is achieved in the short and the long-term follow-up.
背景
分泌性中耳炎（OME）是儿童获得性听力损失和手术的最常见原因。自动充气被认为是OME 的一种替代治疗方法。
目的
本研究旨在比较新的自动充气装置与鼓室置管（VT）手术或手术候补名单中双侧慢性OME 儿童的观察等待治疗结果。
方法
45 例儿童在四周内进行自动充气，45 例接受 VT 手术，23 例作为对照组。自动充气组和对照组进行鼓室图检查，所有组进行听力检查。
结果
自动充气组和 VT 组在 1（=0.19）、6（=0.23）和 12（=0.31）个月时听力改善程度相当，而对照组无明显变化。在自动充气组中，80%的儿童避免了手术，且与 VT 组 34%的并发症发生率相比，没有报告并发症。
结论
与 VT 手术治疗 OME 相比，自动充气在听力阈值方面取得了等效的改善。
意义
自动充气可能是治疗 OME 儿童的合理一线治疗方法，可潜在避免手术。Moniri 自动充气装置耐受性良好，是治疗小儿慢性分泌性中耳炎的有效替代方法，优于鼓室置管。以前的研究表明，自动充气可能会减少儿童分泌性中耳炎的积液；然而，据报道，治疗的顺应性有限、缺乏足够的听力评估、随访时间短以及缺乏与鼓室置管手术的比较数据。开发了一种新装置，允许在幼儿中进行自动充气。在短期和长期随访中，与鼓室置管手术相比，该装置在听力方面取得了等效的改善。
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