Sederberg-Olsen J F, Sederberg-Olsen A E, Jensen A M
Int J Pediatr Otorhinolaryngol. 1983 Apr;5(2):179-87. doi: 10.1016/s0165-5876(83)80023-8.
The incidence of recurrence of secretory middle ear conditions (SMEC) in the course of the first 3 months after extrusion of a grommet was evaluated in 172 tubulated patients in relation to a number of background variables in a stepwise logistic regression analysis. The background variables were: treatment period, 3-month period (season) of extrusion, sex, age, air volume in the middle ear, diagnosis (unilateral/bilateral, suppurative/non-suppurative and consequently antibiotics), other treatment apart from a grommet (paracentesis and/or adenoidectomy), and a history of allergy. There was a definite correlation between the incidence of recurrence and the air volume in the middle ear, as determined by physical volume test, after correction for age, recurrences being most common in ears with a small middle ear volume. In addition, there was a relationship, but not as marked, between the incidence of recurrence and age after correction for the middle ear volume, recurrences being less common in older patients. None of the other background variables played a statistically significant role when correction was made for age and middle ear volume. It is recommended to practise an expectant therapeutic strategy in SMEC in order to eliminate cases with spontaneous remission. In the event of recurrence, a more liberal reinsertion of grommets is recommended for patients with small middle ear volumes, while in those with larger volumes a different aetiology should possibly be considered.
在一项逐步逻辑回归分析中，研究人员评估了172名接受鼓膜置管术的患者在鼓膜通气管拔除后的前3个月内分泌性中耳疾病（SMEC）的复发率，并分析了一些背景变量的影响。这些背景变量包括：治疗时间、拔除通气管的3个月时间段（季节）、性别、年龄、中耳气容量、诊断结果（单侧/双侧、化脓性/非化脓性以及是否使用抗生素）、除鼓膜置管术外的其他治疗（穿刺和/或腺样体切除术）以及过敏史。在校正年龄后，通过物理容量测试确定，中耳气容量与复发率之间存在明确的相关性，中耳气容量小的耳朵复发最为常见。此外，在校正中耳气容量后，复发率与年龄之间也存在关联，但不太明显，老年患者复发较少。在校正年龄和中耳气容量后，其他背景变量均未发挥统计学上的显著作用。建议对分泌性中耳疾病采取观察性治疗策略，以消除自然缓解的病例。如果复发，对于中耳气容量小的患者，建议更宽松地重新置入鼓膜通气管，而对于中耳气容量大的患者，则可能应考虑其他病因。
