Spraggs P D, Robinson P J, Ryan R, East C A, Graham J M
Royal Ear Hospital, London, UK.
Int J Pediatr Otorhinolaryngol. 1995 Mar;31(2-3):207-14. doi: 10.1016/0165-5876(94)01105-7.
This randomised prospective trial compared the efficacy of sodium bicarbonate and hydrogen peroxide ear drops in clearing a blocked tympanostomy tube. Tympanostomy tubes, 110 in number, obstructed with blood or inspissated secretions were randomised into treatment and control groups. Details of the operative procedure were retrospectively collected from the patients notes. The patients were reviewed after 2 weeks for both clinical and tympanometric evidence of clearance of the tube and evidence of complications of the drops. There was no significant therapeutic advantage between the two drops (P > 0.9), but in both treatment arms there was a significant therapeutic advantage over a period of observation (P < 0.05 in both groups). Otorrhoea and pain on instilling the drops occurred with equal incidence in both treatment groups. As obstruction of tympanostomy tubes is a common occurrence which often prompts surgical reventilation, there is great potential for cost savings if conservative treatment can be used effectively. The treatments for obstructed tympanostomy tubes are reviewed and methods of prevention of this common occurrence are discussed.
这项随机前瞻性试验比较了碳酸氢钠耳滴剂和过氧化氢耳滴剂在清除堵塞的鼓膜造孔管方面的疗效。110根因血液或浓缩分泌物堵塞的鼓膜造孔管被随机分为治疗组和对照组。手术操作细节从患者病历中进行回顾性收集。2周后对患者进行复查，以获取鼓膜造孔管通畅的临床和鼓室图证据以及耳滴剂并发症的证据。两种耳滴剂之间没有显著的治疗优势（P>0.9），但在两个治疗组中，经过一段时间的观察都有显著的治疗优势（两组P均<0.05）。两个治疗组中耳漏和滴入耳滴剂时的疼痛发生率相同。由于鼓膜造孔管堵塞很常见，常常促使进行手术再通气，如果能有效采用保守治疗，就有很大的成本节约潜力。本文回顾了堵塞鼓膜造孔管的治疗方法，并讨论了预防这种常见情况的方法。
