Weng Yongcai, Wu Yong, Hao Chunhua, Chu Yanjun, Qian Xiong
Yongcai Weng Department of Otorhinolaryngology, Jiaxing University Affiliated TCM Hospital, Jiaxing, Zhejiang Province 314001, P.R. China.
Yong Wu Department of Otorhinolaryngology, Jiaxing University Affiliated TCM Hospital, Jiaxing, Zhejiang Province 314001, P.R. China.
Pak J Med Sci. 2024 Dec;40(11):2577-2582. doi: 10.12669/pjms.40.11.10713.
To assess the efficacy of combined tympanostomy tube insertion (TTI) and adenoidectomy (Ad) Ad alone in the treatment of otitis media with effusion (OME) in children.
Clinical data of 145 children with OME who underwent surgical treatment in Jiaxing University Affiliated TCM Hospital from January 2022 to November 2023, were retrospectively analyzed. Patients were grouped based on whether or not Ad was performed with TTI: children who underwent Ad alone were grouped as Ad group (n=71), and children who underwent a combined TTI and Ad were grouped as TTI+Ad group (n=74). Clinical efficacy, clinical indicators (recovery of hearing, disappearance of tinnitus, eardrum healing, and disappearance time of middle ear effusion), serum levels of inflammatory factors, recurrence, and incidence of complications were compared between the two groups.
Combined TTI+Ad resulted in a significantly better therapeutic effect three months after the surgery compared Ad alone (<0.05). Combined treatment was associated with significantly shorter time needed for hearing recovery, disappearance of tinnitus, eardrum healing, and disappearance of middle ear effusion (<0.05). Combined procedure significantly lowered levels of inflammatory factors (<0.05), and was associated with lower postoperative recurrence rate (<0.05) compared to Ad alone. There was no significant difference in the incidence of complications between the two methods of surgical OME treatment (>0.05).
Compared to Ad alone, combined TTI+Ad treatment is equally safe and more effective in the treatment of OME in children. This surgical approach is associated with reduced local inflammatory reactions and lower recurrence rate.
评估鼓膜置管（TTI）联合腺样体切除术（Ad）与单纯腺样体切除术治疗儿童分泌性中耳炎（OME）的疗效。
回顾性分析2022年1月至2023年11月在嘉兴学院附属中医医院接受手术治疗的145例OME患儿的临床资料。根据是否在鼓膜置管时同时进行腺样体切除术将患者分组：单纯接受腺样体切除术的儿童分为Ad组（n = 71），接受鼓膜置管联合腺样体切除术的儿童分为TTI + Ad组（n = 74）。比较两组的临床疗效、临床指标（听力恢复、耳鸣消失、鼓膜愈合及中耳积液消失时间）、血清炎症因子水平、复发情况及并发症发生率。
与单纯腺样体切除术相比，鼓膜置管联合腺样体切除术在术后3个月时治疗效果显著更好（P<0.05）。联合治疗使听力恢复、耳鸣消失、鼓膜愈合及中耳积液消失所需时间显著缩短（P<0.05）。联合手术显著降低了炎症因子水平（P<0.05），与单纯腺样体切除术相比，术后复发率更低（P<0.05）。两种分泌性中耳炎手术治疗方法的并发症发生率无显著差异（P>0.05）。
与单纯腺样体切除术相比，鼓膜置管联合腺样体切除术治疗儿童分泌性中耳炎同样安全且更有效。这种手术方法可减轻局部炎症反应并降低复发率。
