Maw A R, Bawden R
Department of Otolaryngology, Bristol Royal Infirmary, UK.
Clin Otolaryngol Allied Sci. 1994 Apr;19(2):125-30. doi: 10.1111/j.1365-2273.1994.tb01195.x.
There is only limited knowledge of the factors which influence the outcome of otitis media with effusion in children in the long-term. This randomized controlled study assessed the therapeutic effect of adenoidectomy and adenotonsillectomy during a 5-year follow-up. Numerous pre-treatment independent variables concerning the child's upper and lower respiratory tract, atopic status and parental habits were assessed in relation to two dependent outcome measures. These were otoscopic clearance of effusion and no peak/peak tympanometric change. A total of 222 children was studied and reviewed annually for 5 years. Four of 43 independent variables were found to be repeatedly significant in relation to outcome: (a) whether or not adenoidectomy was performed; (b) age at operation; (c) history of earache prior to operation; and (d) parental smoking habits. The results provide further evidence of a beneficial effect of adenoid removal and the importance of the age at which surgery is advised. They also suggest the need to investigate further the relationship of superadded acute suppurative otitis media with otalgia and the outcome of chronic otitis media with effusion. Finally, avoidance of parental smoking will have a beneficial effect on children's middle ear disease.
关于影响儿童分泌性中耳炎长期预后的因素，目前所知有限。这项随机对照研究在5年的随访期间评估了腺样体切除术和腺样体扁桃体切除术的治疗效果。针对两项相关的预后指标，评估了众多与儿童上、下呼吸道、特应性状态及父母习惯有关的治疗前独立变量。这两项指标分别为耳镜检查中耳积液清除情况以及鼓室导抗图无峰值/峰值变化。共有222名儿童接受了研究，并在5年期间每年进行复查。结果发现，43项独立变量中有4项与预后反复显著相关：(a) 是否进行了腺样体切除术；(b) 手术年龄；(c) 术前耳痛病史；以及(d) 父母的吸烟习惯。研究结果进一步证明了腺样体切除的有益效果以及建议手术年龄的重要性。它们还表明有必要进一步研究急性化脓性中耳炎伴耳痛与慢性分泌性中耳炎预后之间的关系。最后，父母避免吸烟将对儿童中耳疾病产生有益影响。
