Muenker G
Ann Otol Rhinol Laryngol Suppl. 1980 May-Jun;89(3 Pt 2):308-11. doi: 10.1177/00034894800890s372.
Otitis media with effusion will be observed in every fifth child admitted for adenoid surgery; in children with cleft palates the incidence is 50%. With adenoidectomy alone, normal hearing can be restored in 50% and improved in further 25% of the patients. Over a 12-year period 1,683 patients with otitis media with effusion were treated with adenoidectomy and with insertion of tympanostomy tubes in those cases where adenoidectomy proved to be ineffective. Since the tubes only substitute tubal function, recurrences have to be expected in more than 30% after spontaneous extrusion of the tubes. Of all recurrences, 93% occur within two years after tube insertion. With thorough follow-up and repeated insertion of tubes, deterioration of the middle-ear can be avoided and hearing kept normal. Impaired bone conduction does not reflect inner ear damage, but will improve with ventilation of the middle ear. Infections occur in 15% (5% postoperatively, 10% later); persistent perforations in 2.5% and cholesteatoma in 0.9%.
每五个因腺样体手术入院的儿童中就有一个会出现中耳积液；腭裂儿童的发病率为50%。仅行腺样体切除术，50%的患者听力可恢复正常，另有25%的患者听力会有所改善。在12年的时间里，1683例中耳积液患者接受了腺样体切除术，对于腺样体切除术无效的病例则插入鼓膜造孔管。由于这些管子仅替代咽鼓管功能，管子自行排出后，超过30%的患者会复发。在所有复发病例中，93%发生在插管后两年内。通过全面的随访和反复插管，可以避免中耳恶化并保持听力正常。骨导受损并不反映内耳损伤，但会随着中耳通气而改善。感染发生率为15%（术后5%，后期10%）；持续性穿孔发生率为2.5%，胆脂瘤发生率为0.9%。
