Fior R, Veljak C
Int J Pediatr Otorhinolaryngol. 1984 Dec;8(2):139-46. doi: 10.1016/s0165-5876(84)80062-2.
We have evaluated from a clinical and functional point of view a total of 61 children (37 boys and 24 girls with a median age of 3 years, range 4 months to 6 years) who had been submitted before 1978 to insertion of tympanostomy tubes (in a total of 131 ears) for prophylaxis of recurrent purulent otitis media. Of these, 67.6% remained free from recurrencies after removal or extrusion of grommets, whereas in the remaining group discharge could be cured with local and/or general antibiotic treatment. Sixteen cases had tympanic calcifications, 6 an atrophic drum, and 10 a severe tympanic retraction, but only 8 out of these 32 cases had signs of conductive hearing loss (average loss 20 dB on frequencies from 500 to 2000 Hz). Further complications observed in this follow-up have been perforations (6 cases) and one case of migration of the tube into the tympanic cavity. No cholesteatoma has been observed in our series. A few considerations can be drawn from these observations: insertion of grommets, correctly performed in the anterior-inferior part of the drum appears to prevent a large percentage of recurrencies, and should therefore be considered, even in the long-term, an adequate prophylaxis for the otitis-prone child; complications as seen during a long follow-up period are relatively few, can be cured, and have a modest functional impact.
我们从临床和功能角度评估了总共61名儿童（37名男孩和24名女孩，中位年龄3岁，范围4个月至6岁），这些儿童在1978年前曾因预防复发性化脓性中耳炎而插入鼓膜置管（共131只耳朵）。其中，67.6%的儿童在鼓膜置管取出或自行排出后未再复发，而其余儿童的耳漏可通过局部和/或全身抗生素治疗治愈。16例有鼓膜钙化，6例鼓膜萎缩，10例鼓膜严重内陷，但这32例中只有8例有传导性听力损失迹象（500至2000赫兹频率平均损失20分贝）。本次随访中观察到的其他并发症有鼓膜穿孔（6例）和1例置管移入鼓室。我们的系列病例中未观察到胆脂瘤。从这些观察结果可以得出一些结论：在鼓膜前下部正确置入鼓膜置管似乎能预防很大比例的复发，因此即使从长期来看，也应被视为对易患中耳炎儿童的一种充分预防措施；长期随访期间出现的并发症相对较少，可以治愈，且对功能影响不大。
