Bonding P, Tos M
Am J Otol. 1985 Nov;6(6):455-60.
One hundred and ninety-three consecutive children with bilateral secretory otitis media were treated by adenoidectomy, bilateral paracentesis, and evacuation of middle ear effusion, but with insertion of a grommet in the right ear only. At follow-up one to three years later, the audiometric and tympanometric results were similar in right and left ears. The primary advantage of grommet insertion was normalization of the hearing ability for as long as the grommet was functioning. Thus, only 1% of the ears with grommets had hearing losses exceeding 30 dB HL, whereas this occurred in about 20% of ears without grommets. The adverse effects of grommet insertion included periodic aural discharge during the functioning period of the grommet in 14% and tympanosclerosis of the drum in 48%. In the group of ears treated with paracentesis only, tympanosclerosis occurred in 10%. However, reinsertion of grommets was indicated in 10% of right ears, and 23% of left ears required grommets as well. Of the various pre- and perioperative factors analyzed, only a granulating mucous membrane and copious middle ear effusion could be correlated to frequent and protracted episodes of secretory otitis that required repeated treatment. The implications of these findings are discussed.
193例双侧分泌性中耳炎患儿接受了腺样体切除术、双侧鼓膜穿刺及中耳积液引流，但仅在右耳置入了通气管。在1至3年后的随访中，双耳的听力测定和鼓室图结果相似。通气管置入的主要优点是只要通气管发挥作用，听力就能恢复正常。因此，置入通气管的耳朵中只有1%的听力损失超过30 dB HL，而未置入通气管的耳朵中约有20%出现这种情况。通气管置入的不良反应包括在通气管发挥作用期间有14%出现周期性耳漏，48%出现鼓膜鼓室硬化。仅接受鼓膜穿刺治疗的耳朵中，鼓室硬化发生率为10%。然而，10%的右耳需要再次置入通气管，23%的左耳也需要置入通气管。在分析的各种术前和围手术期因素中，只有肉芽形成的黏膜和大量中耳积液与需要反复治疗的分泌性中耳炎频繁和持久发作有关。讨论了这些发现的意义。
