Yoo Myung Hoon, Cho Yang-Sun, Choi June, Choung Yun Hoon, Chung Jae-Ho, Chung Jong Woo, Han Gyu Cheol, Jun Beom Cho, Kim Dong-Kee, Kim Kyu Sung, Lee Jun Ho, Lee Kyu-Yup, Lee Seung Hwan, Moon In Seok, Park Hong Ju, Park Shi Nae, Rhee Jihye, Seo Jae Hyun, Yeo Seung Geun
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2022 Nov;15(4):326-334. doi: 10.21053/ceo.2022.00934. Epub 2022 Sep 1.
The impacts of ventilation tube (VT) type and effusion composition on the VT extrusion rate and complications in children with otitis media remain unclear. This part II study evaluated the factors affecting the extrusion rate, recurrence rate, and complications of VT insertion.
A prospective study was conducted between June 2014 and December 2016 (the EVENT study [analysis of the effectiveness of ventilation tube insertion in pediatric patients with chronic otitis media]), with follow-up data collected until the end of 2017. Patients aged <15 years diagnosed with otitis media with effusion who received VT insertion were recruited at 15 tertiary hospitals. The primary outcomes were time to extrusion of VT, time to effusion recurrence, and complications.
Data from 401 patients were analyzed. After excluding the.
of long-lasting tubes (Paparella type II and T-tubes), silicone tubes (Paparella type I) exhibited a significantly longer extended time to extrusion (mean, 400 days) than titanium tubes (collar-button-type 1.0 mm: mean, 312 days; P<0.001). VT material (hazard ratio [HR], 2.117, 95% confidence interval [CI], 1.254-3.572; P=0.005), age (HR, 3.949; 95% CI, 1.239-12.590; P=0.02), and effusion composition (P=0.005) were significantly associated with the time to recurrence of middle ear effusion. Ears with purulent (mean, 567 days) and glue-like (mean, 588 days) effusions exhibited a shorter time to recurrence than ears with serous (mean, 846 days) or mucoid (mean, 925 days) effusions. The revision VT rates during follow-up were 3.5%, 15.5%, 10.4%, and 38.9% in ears with serous, mucoid, glue-like, and purulent effusions, respectively (P<0.001). The revision surgery rates were higher among patients aged <7 years than among those aged ≥7 years.
Silicone tubes (Paparella type I) were less prone to early extrusion than titanium 1.0 mm tubes. VT type, patient age, and effusion composition affected the time to recurrence of effusion.
通气管（VT）类型和积液成分对中耳炎患儿VT挤出率及并发症的影响尚不清楚。本研究的第二部分评估了影响VT置入后挤出率、复发率及并发症的因素。
于2014年6月至2016年12月进行了一项前瞻性研究（EVENT研究[小儿慢性中耳炎患者通气管置入效果分析]），随访数据收集至2017年底。在15家三级医院招募了年龄<15岁、被诊断为中耳积液并接受VT置入的患者。主要结局指标为VT挤出时间、积液复发时间及并发症。
分析了401例患者的数据。排除……结果后。
在排除长效通气管（Paparella II型和T型管）后，硅胶管（Paparella I型）的延长挤出时间（平均400天）显著长于钛管（1.0 mm领扣型：平均312天；P<0.001）。VT材料（风险比[HR]，2.117，95%置信区间[CI]，1.254 - 3.572；P = 0.005）、年龄（HR，3.949；95% CI，1.239 - 12.590；P = 0.02）和积液成分（P = 0.005）与中耳积液复发时间显著相关。脓性积液（平均567天）和胶样积液（平均588天）的耳朵比浆液性积液（平均846天）或黏液性积液（平均925天）的耳朵复发时间短。随访期间，浆液性、黏液性、胶样和脓性积液耳朵的VT翻修率分别为3.5%、15.5%、10.4%和38.9%（P<0.001）。年龄<7岁患者的翻修手术率高于年龄≥7岁的患者。
硅胶管（Paparella I型）比1.0 mm钛管更不易早期挤出。VT类型、患者年龄和积液成分影响积液复发时间。
