Aaronson Nicole L, Blackwell Allison, Kenine Onyinyechi, Vanella Emily, Lu Zhaoying, Nardone Heather
Nemours Children's Division of Otolaryngology, Department of Surgery, Nemours Children's Health, Delaware Valley, Wilmington, Delaware, U.S.A.
Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
Laryngoscope. 2025 Jun;135(6):2171-2175. doi: 10.1002/lary.31957. Epub 2025 Jan 31.
Tympanostomy tube removal is a common procedure, the most common complication of which is persistent perforation. Multiple surgical techniques exist. This study seeks to determine whether the technique used affects success rate or surgical time.
This was a retrospective cohort study in a tertiary-care children's hospital. Tube removal procedure codes were used to extract charts from 2008 to 2023. Data were collected on surgical technique, success, operative time, indications, and patient factors. Primary outcome measure was surgical success, defined as no residual perforation.
A total of 1562 patient ears were analyzed. Success rate was 95.5% for trichloroacetic acid (TCA) myringoplasty with patch, 86.5% for cold myringoplasty with patch placement (CMwP), 74.7% for cold myringoplasty without patch placement (CMsP), and 73.8% for tube removal alone (TR). TR as compared with CMsP did not show a difference in closure rates (p = 1.0000). CMwP was more likely to be successful than TR (p = 0.0162) or CMsP (p = 0.0117). TCA was more likely to be successful than CMwP (p = 0.0197). Median operative time was 4 min for TR, CMsP, and CMwP and 5 min for TCA. This difference in operative time between the groups was statistically significant (p < 0.001).
TCA myringoplasty with patch shows greater surgical success rate than cold myringoplasty with patch, cold myringoplasty without patch, or tube removal alone, but it has a longer operative time. Cold myringoplasty with patch has greater surgical success than cold myringoplasty without patch or tube removal alone.
3 Laryngoscope, 135:2171-2175, 2025.
鼓膜置管取出术是一种常见的手术，其最常见的并发症是持续性穿孔。存在多种手术技术。本研究旨在确定所使用的技术是否会影响成功率或手术时间。
这是一项在三级儿童医院进行的回顾性队列研究。使用鼓膜置管取出术的程序编码从2008年至2023年提取病历。收集了关于手术技术、成功率、手术时间、适应证和患者因素的数据。主要结局指标是手术成功，定义为无残余穿孔。
共分析了1562例患者的耳朵。使用三氯乙酸（TCA）鼓膜成形术加补片的成功率为95.5%，冷鼓膜成形术加补片放置（CMwP）的成功率为86.5%，冷鼓膜成形术不加补片放置（CMsP）的成功率为74.7%，单纯鼓膜置管取出术（TR）的成功率为73.8%。TR与CMsP相比，闭合率无差异（p = 1.0000）。CMwP比TR（p = 0.0162）或CMsP（p = 0.0117）更有可能成功。TCA比CMwP更有可能成功（p = 0.0197）。TR、CMsP和CMwP的中位手术时间为4分钟，TCA为5分钟。各组之间的手术时间差异具有统计学意义（p < 0.001）。
TCA鼓膜成形术加补片的手术成功率高于冷鼓膜成形术加补片、冷鼓膜成形术不加补片或单纯鼓膜置管取出术，但手术时间更长。冷鼓膜成形术加补片比冷鼓膜成形术不加补片或单纯鼓膜置管取出术具有更高的手术成功率。
3 喉镜，135:2171 - 2175，2025年。
