University of Split, School of Medicine, Split, Croatia.
University of Split, Split University Hospital Center, Department of Otorhinolaryngology, Split, Croatia.
Acta Clin Croat. 2023 Aug;62(2):300-307. doi: 10.20471/acc.2023.62.02.07.
The objective was to determine the range of hearing improvement (in dB) post ventilation tube insertion in children with chronic otitis media with effusion (COME), and whether there was a difference in hearing improvement between age groups and genders. This study also investigated whether there was a difference in the mean hearing improvement between the left and right ear, how many months passed before recovery of eustachian tube function, and how long the aeration of the middle ear lasted. The children included in the study were between six and twelve years of age, diagnosed with COME by audiological processing (type B tympanometric recording and conductive hearing loss up to 40 dB on pure tone audiometry) and underwent surgical insertion of ventilation tubes in both ears. Patient data included preoperative tympanometric records, preoperative and postoperative tone audiometry findings, tubometry findings 6 and 10 months after insertion of ventilation tubes, age and gender data, and length of time during which the tubes were in place. The mean hearing improvement of the included patients was 24.2 dB on the right ear and 24.5 dB on the left ear. There was no statistically significant difference between the left and right ear or between the genders. Older age groups had a higher mean hearing improvement compared with the younger age group. Younger age groups had a longer expected period of eustachian tube function recovery, and were expected to have ventilation tubes inserted for a longer period of time. Treatment with ventilation tube insertion resulted in significant improvement in hearing in children where previous conservative therapy failed to recover eustachian tube function and improve hearing. Although children of older age groups had greater preoperative hearing impairment, the recovery of both eustachian tube function and hearing improvement was faster, and the mean length of time that the ventilation tubes had to be inserted was shorter.
目的在于确定患有分泌性中耳炎(OME)的儿童在接受鼓室置管术后听力提高的范围(以 dB 为单位),以及年龄组和性别之间的听力提高是否存在差异。本研究还调查了左右耳之间的平均听力提高是否存在差异,咽鼓管功能恢复前需要经过多少个月,以及中耳通气持续多长时间。研究纳入的儿童年龄在 6 至 12 岁之间,通过听力学处理(B 型鼓室压图记录和纯音测听的传导性听力损失达 40dB)诊断为OME,并在双耳接受了鼓室置管手术。患者数据包括术前鼓室压图记录、术前和术后纯音测听结果、置管 6 个月和 10 个月后的鼓室图结果、年龄和性别数据,以及置管时间。纳入患者的右耳平均听力提高为 24.2dB,左耳为 24.5dB。左右耳之间或性别之间没有统计学上的显著差异。年龄较大的年龄组与年龄较小的年龄组相比,平均听力提高更高。年龄较小的年龄组预计咽鼓管功能恢复时间更长,预计需要更长时间插入通风管。对于之前保守治疗未能恢复咽鼓管功能和改善听力的儿童,鼓室置管治疗可显著改善听力。尽管年龄较大的儿童术前听力障碍更严重,但咽鼓管功能和听力改善的恢复速度更快,需要插入通气管的平均时间更短。