摘要
目的探讨根据鼓室积液物理特性区别处理伴发于腺样体肥大的分泌性中耳炎临床价值。方法对2006年1月～2008年1月在我院手术的伴发于腺样体肥大的分泌性中耳炎患者按其鼓室积液物理特性进行区别处理。鼓室积液量多黏稠时,行鼓膜置管术;鼓室积液量少稀薄时,仅行鼓膜穿刺抽液。所有患者同时行腺样体切除术。结果鼓膜置管组167例255耳。术后2年时,声阻抗A型者76.1%。分泌性中耳炎复发者13.3%;中耳感染流脓者9.8%;取管后鼓膜穿孔未愈者3.9%;置管堵塞10.5%,过早脱落14.5%。鼓膜未予置管组68例88耳。术后2年时,声阻抗A型者92.0%。分泌性中耳炎复发者2.3%;中耳感染流脓者1.1%。未予鼓膜置管者,其治愈率优于鼓膜置管者,分泌性中耳炎复发率、鼓膜穿孔率等则明显低于鼓膜置管者(P﹤0.01)。结论对伴发于腺样体肥大的分泌性中耳炎,根据鼓室积液物理特性区别处理,具有一定的临床价值。
OBJECTIVE To evaluate the value of different treatment for secretory otitis media based on the character of effusion in patients with adenoid vegetation.METHODS Different treatment strategy were applied for secretory otitis media based on the character of effusion in the tympanic cavity of the patients with adenoid vegetation treated at this institute from January 2006 to January 2008.Myringotomy with tympanic tube insertion was adopted when the effusion was sticky,and tympanocentesis for thin effusion.All the patients accepted the adenoidectomy.RESULTS Normal peaked tympanogram was 76.1% out of the 167 cases（255 ear in total）of tympanostomy tube insertion group at 2 years postoperatively.From the tympanotomy tube insertion group during the follow-up period,the incidence of recurrence of secretory otitis media was 13.3%,middle ear infection was 9.8%,permanent tympanic membrane perforation was 3.9%,tympanic tube blockage was 10.5%,and the tube off the tympanic membrane was 14.5%.Normal peaked tympanogram was 92.0% in the tympanocentesis group at 2 years postoperatively.From the 68 cases（88 ears in total）of tympanocentesis group during 2 years of follow-up,incidence of recurrence of secretory otitis media was 2.3%,and middle ear infection was 1.1%.The cure rate of otitis media with effusion in the tympanocentesis group was significantly higher than that of myringotomy tube insertion group,and both the incidence of recurrence of secretory otitis media and the incidence of permanent tympanic membrane perforation in the tympanocentesis group were lower than those of tympanotomy tube group.CONCLUSION It is practical to apply different treatment strategy for secretory otitis media based on the character of effusion in the tympanic cavity of the patients with adenoid vegetation.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2011年第6期299-301,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
上海市卫生局基金项目(20070154)
上海市自然科学基金项目(08ZR1414900)联合资助
关键词
中耳炎
伴渗出液
增殖腺
临床方案
鼓膜置管
鼓室积液
Otitis Media with Effusion
Adenoids
Clinical Protocols
tympanic tube insertion
effusion in the tympanic cavity
