Alshammari Majidah S, AlOthman Sarah A, Sindi Abdullah, Al-Khatib Talal
Otolaryngology, Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU.
Otorhinolaryngology, Head and Neck surgery, Faculty of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, SAU.
Cureus. 2022 Dec 17;14(12):e32633. doi: 10.7759/cureus.32633. eCollection 2022 Dec.
Background Tympanostomy ventilation tube (VT) insertion is one of the most common procedures performed in otorhinolaryngology. VTs have been proven to effectively manage otitis media (OM) with effusion (OME) and to improve the quality of life of children postoperatively. Although there are multiple types of VT shapes, materials, and sizes, few studies have investigated and compared the effects of titanium VT with those of VTs made of other materials. This study aimed to compare titanium VTs and the more commonly used fluoroplastic VTs in a retrospective, age-matched, case-control study. We studied the postoperative outcomes and rates of extrusion, infection, otorrhea, tube obstruction, and residual perforation. Methodology Medical records of patients who underwent myringotomy with VT insertion from January 2018 to December 2020 were reviewed. A total of 34 patients met the inclusion criteria, of whom 17 had undergone titanium VT insertion bilaterally (titanium group) and 17 had undergone fluoroplastic VT insertion bilaterally (control group). Both groups were followed up with regular postoperative examinations for 18 months. Results Postoperative complications were categorized as early and late complications. The most common early postoperative complication was early extrusion of VT (six months or less after insertion) (67.6%); this was documented most often in the titanium group. Other early postoperative complications included transient otorrhea (14.7%), tube blockage (8.8%), and recurrent acute otitis media (AOM) (occurring within one month from completion of therapy of AOM episode) (5.9%); these rates were similar in both groups. Late complications were not significantly variable between groups. Tympanic membrane retraction was the most common late complication (8.8%). Conclusions VT insertion is associated with the risk of complications with varying degrees. Although factors affecting the VT complication rates are multiple and various, these rates were not different between groups in this study. However, further studies including larger population samples are needed to statistically confirm these results and their generalizability.
背景 鼓膜置管术是耳鼻咽喉科最常见的手术之一。鼓膜置管已被证明能有效治疗分泌性中耳炎(OME),并改善患儿术后的生活质量。尽管鼓膜置管有多种形状、材料和尺寸,但很少有研究调查和比较钛质鼓膜置管与其他材料鼓膜置管的效果。本研究旨在通过一项回顾性、年龄匹配的病例对照研究,比较钛质鼓膜置管和更常用的氟塑料鼓膜置管。我们研究了术后结果以及置管脱出、感染、耳漏、管堵塞和残余穿孔的发生率。
方法 回顾了2018年1月至2020年12月期间接受鼓膜切开置管术患者的病历。共有34例患者符合纳入标准,其中17例双侧接受钛质鼓膜置管(钛质组),17例双侧接受氟塑料鼓膜置管(对照组)。两组均在术后定期检查,随访18个月。
结果 术后并发症分为早期和晚期并发症。最常见的早期术后并发症是鼓膜置管早期脱出(置管后6个月或更短时间)(67.6%);这在钛质组中记录最为常见。其他早期术后并发症包括短暂性耳漏(14.7%)、管堵塞(8.8%)和复发性急性中耳炎(在急性中耳炎发作治疗完成后1个月内发生)(5.9%);两组的这些发生率相似。晚期并发症在两组之间无显著差异。鼓膜内陷是最常见的晚期并发症(8.8%)。
结论 鼓膜置管术存在不同程度的并发症风险。尽管影响鼓膜置管并发症发生率的因素多种多样,但本研究中两组的这些发生率并无差异。然而,需要进一步纳入更大样本量人群的研究来从统计学上证实这些结果及其普遍性。